The allure of Texas to tort reform backers is unmistakable. It also has proved a red herring. You’ve probably read about how Proposition 12, Texas’ 10-gallon tort reform, has rejuvenated our neighbor’s health care system and made the state a haven for well-intentioned doctors fleeing runaway juries.

Too bad things aren’t that simple. Nothing gets in the way of a good tale like the truth.

“Five years later, the ($250,000) cap is being credited for slashing liability insurance premiums, boosting the ranks of doctors in the state, and improving medical access to patients,” the American Medical Association crowed last month (See “5 years of tort reform: Lone Star success story,” American Medical News, Sept. 15, 2008).

Yes, tort reform has brought doctors to Texas. They just haven’t flocked to areas that need them most, undercutting what was perhaps supporters’ strongest argument in favor of passing the constitutional amendment.

The Texas Observer chronicled the influx of doctors (See “Baby, I Lied,” Oct. 19, 2007) and made some disturbing findings.

Prior to Proposition 12’s passage 152 counties had no obstetrician. Four years later the number remained the same. Moreover, 49 percent of Texas counties had no obstetrician, neurosurgeon or orthopedic surgeon, and a number of counties had no physicians. “Proposition 12, and the far-reaching changes in Texas civil law that it dragged behind it, was built on a foundation of mistruths and sketchy assumptions. The number of doctors in the state was not falling, it was steadily rising,” the newspaper reported, citing Texas Medical Board data. “There was little statistical evidence showing that frivolous lawsuits were a significant force driving increases in malpractice premiums.

“The campaign’s promise, that tort reform would cause doctors to begin returning to the state’s sparsely populated regions, has now been tested for four years. It has not proven to be true,” the newspaper concluded.

A study in the recent issue of Health Affairs examined county-by-county data to determine how often doctors move, where they go and why they go there (See “The Diffusion Of Physicians,” September/October 2008).

“The overall tendency of movers was to go to places with lower physician-to-population ratios but higher per capita incomes and lower unemployment,” the authors wrote. “These trends, if they continue, may help decrease access to physician care in rural and urban underserved areas.”

Doctors, it turns out, move for many of the same reasons the rest of us move and choose many of the same places.

However, the most important factor in where physicians choose to practice, the authors found, is residency location.

Research shows Oklahoma doesn’t have a shortage of doctors, either.

The Journal Record newspaper (See “Is Oklahoma losing doctors?” April 3, 2008) found 4,787 medical doctors and 880 medical and osteopathic physicians, respectively, practiced in the state in 1997. By 2007 the numbers had risen to 5,718 and 1,324, respectively.

Oklahoma’s mid-2007 population estimate was 3,617,316, Census data show. Its mid-1997 population estimate was 3,372,900. This is a 7 percent increase.

The state’s doctor population grew by 24 percent during the same decade.

If improving access to health care is the goal, tort reform has failed to live up to its promise in the Lone Star State. That’s one distinction we should let Texas keep.



JEFF RAYMOND is executive director of the Oklahoma Foundation for Consumer & Patient Rights.