Doctors nationwide are relocating to Texas four years after a constitutional amendment was adopted in the state that limits awards in medical malpractice lawsuits, the New York Times reports (Blumenthal, New York Times, 10/5). In September 2003, Texas voters passed Proposition 12, a ballot measure that amended the state constitution to allow state lawmakers to pass legislation to cap damages in medical malpractice lawsuits. Gov. Rick Perry (R) in 2004 signed into law a bill that caps noneconomic damages in malpractice lawsuits at $250,000 for physicians, $250,000 for hospitals and $250,000 for nursing homes and other health care facilities. The legislation also caps total noneconomic damages in malpractice lawsuits at $750,000 per plaintiff. The law does not cap economic damages (Kaiser Daily Health Policy Report, 9/28/04).

The state medical board now is backlogged with applications from doctors seeking to practice in the state, with 2,500 applications pending at last count. The number of licenses issued jumped 30% in the last fiscal year, and there has been an overall increase of 18% since 2003, according to Donald Patrick, executive director of the Texas Medical Board, a neurosurgeon and lawyer. "Doctors are coming to Texas because they sense a friendlier malpractice climate," Patrick said.

However, some experts "say the picture may be more complicated and less positive," the Times reports, questioning "how big a role the cap in malpractice awards has played." In addition, some critics "question whether the changes have left patients more vulnerable," asserting that with "doctors facing reduced malpractice exposure, ... many have cut back on their insurance, making it harder for plaintiffs to collect damages," according to the Times.

Comments
N. Alex Winslow, executive director of consumer group Texas Watch, said, "We've lost our system of legal accountability. Just having more doctors doesn't make patients safer. It remains to be seen who is coming to our state."

Paula Sweeney, a liability lawyer in Dallas and a past president of the Texas Trial Lawyers Association, said, "A lot of legislators are aware they went too far in 2003." However, many doctors and other supporters believe the limits have improved conditions in Texas.

Timothy George, a pediatric neurosurgeon who in part credits the limits with attracting him to move from North Carolina to Austin, said, "Texas made it easier to practice and easier to take care of complex patients" (New York Times, 10/5).

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