Friday, October 5, 2007

Texas Tort "Reform" and the New YorkTimes

The New York Times reports today on the huge increase in doctors flooding into the Texas since medical malpractice damages were severely capped in 2003. Want to know what else has gone up? Patient complaints and actions against doctors by the Texas Medical Board.

The article quotes an official as saying that disciplinary actions have risen only 8 percent. But is that really true? Not when I look at the numbers.

Here's the quote buried on page 2:

Since 2003, investigations of doctors have gone up 40 percent, patient complaints have gone up 25 percent, and disciplinary actions about 8 percent, said Jill Wiggins, a board spokeswoman.

Maybe that official isn't looking at these statistics. Nor, apparently was the New York Times.

Total Disciplinary Actions:
2002: 187
2003: 277
2004: 256
2005: 304
2006: 335

If you measure from 2002, the last full year before the caps were imposed, then disciplinary actions rose 79%. If one is going to do a "before" and "after" comparison that seems the likely year to use.

If, on the other hand, you are trying to spin the New York Times to claim only a minimal change, then you ignore the rapid increase over four years and minimize the damage by only discussing the change from 2005 to 2006.

By the way, 2007 isn't shaping up much better, with 88 doctors disciplined at the Medical Board's August meeting, 30 in June, 34 in April, and 41 in February. That's 193 so far, with two more meetings to go, on a pace to well exceed the 2002 numbers.

So Texas is clearly getting more doctors. They just might not be the ones you want.

See also:

• More Docs Messin' w/ Texas ...While Texas Messes with Patient-Plaintiffs (TortDeform)
• Well What Do You Know - Tort Reform Works (AnkleBitingPundits)
• Medical Malpractice Caps Work (Health Care BS)
• Texas: A Study in Tort Reform (Below the Beltway)
• How About that Tort Reform (Off the Kuff)
• Medical Malpractice: More Docs in Texas (Perlmutter & Schuelke)
• After Texas Caps Malpractice, Docs Move In (WSJ Health Blog)
  

(Eric Turkewitz is a personal injury attorney in New York)

Labels: tort reform

posted by Eric Turkewitz  # Permanent Link

Comments:

When disciplinary numbers were low, trial lawyers complained that the Board wasn't acting aggressively enough, and malpractice liability was needed. Now that they're not low, trial lawyers are complaining that tort reform caused an increase in discipline, and malpractice liability is needed. I detect a theme, if not an internally consistent one.

# posted by  Ted F. : October 05, 2007 1:41 PM

 

Ted:

If a state has a disciplinary record that is out of whack with other states, then I think we can agree that there is an enforcement problem.

And if a state attracts individuals because an industy is given various levels of immunity and protections from negligent conduct, then it is fair to conclude that the bottom of the barrel will flock there. There may also be others who go, but you can be sure it will attract a disproportionate number from the bottom.

# posted by  Eric Turkewitz : October 05, 2007 2:13 PM

 

Lies, Damn lies and then statistics right eric. Indiviudal state's aggressiveness for disciplining doctors waxes and wanes over time. Arizona used to be historically weak, now it is very aggressive with many more doctor's disciplined than in the 90's. Does that mean doctors there are getting worse? One does not necessarily correlate with the other Eric and you know that. Quit playing the bait game. If you wanted to see some type of association between increase MD migration and the quality of those docs who are coming in, then you would need to compare the new docs and % of disciplinary cases with all docs and % of cases. I guess you didn't take a stats class in college now did your eric.

# posted by  Anonymous : October 06, 2007 5:40 PM

 

There may be many reasons for the increase in disciplinary actions, but that doesn't excuse the New York Times for blowing the story on the increase. It isn't 8%, as they claimed, but about 10x higher.

The reasons for the increase in actions may be related to increased enforcement, to docs taking more risks now that they have some protections and immunities from negligent conduct, to bad docs coming in to the state, etc.

But I think it is clear that, when you give any industry immunities and protections from negligence, that the higher risk players in that industry will flock to that jurisdiction.

Sadly, with the Medical Board spokesperson already giving out spun statistics, like claiming there was only an 8% increase in disciplinary actions when the number is clearly higher, it makes it hard to believe much of anything else they might say. And that makes doing a good analysis even more difficult.

# posted by  Eric Turkewitz : October 07, 2007 12:04 PM

 

thanks for posting the overlooked stats. i agree with poster above: to address this issue responsibly, you look at disciplinary record of docs who started practicing in TX after 2003.

anyone know whether the TX board can provide those figures? or what the TX board says is the reason for the increase in disciplinary actions?

matt fleischer-black

# posted by  Matt : October 10, 2007 11:10 AM

 

What about the rate of actions to the number of licensed physicians? An increase in the population naturally will lead to an increase in the actions.

# posted by  Karen Harker, MPH : October 11, 2007 12:33 PM

 

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