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LEGISLATIVE
ACCOMPLISHMENTS

(continued from page 14)
other Lower Rio Grande Valley physicians led a
huge rally with patients and colleagues at the Hi-
dalgo County Courthouse, one of several simulta-
neous rallies to protest insurance rates and the
litigation-friendly climate. Doctors also rallied in
Nueces County and elsewhere. Dr. Cardenas says
at least 2,000 people joined forces at the Hidalgo
County rally.
“That rally was the spark that lit the fire that ulti-
mately, I think, ended in tort reform,” he said. “It
was a whole choir of folks that sang with one voice.”

FIGHTING FOR PRESERVATION
Looking at data through 2016, the TAPA report
also found that six of eight specialties saw an
uptick in physicians per-capita in Texas post-re-
form. Emergency medicine had the highest increase in number of There are still ways around that; if you can prove that the doctor
physicians at 120 percent. The number of pediatric surgeons per knowingly or willingly provided bad care, then it provides additional
capita increased by nearly 50 percent. ways to compensate those patients when harm occurs,” he said. “But
“The evidence does suggest that meaningful reform had a signif- you also have to weigh the individual against the ability for the pop-
icant impact on the supply of physicians per capita, and therefore ulation to access health care.”
had a significant favorable impact on the access that Texas residents TMA always looks for opportunities to smooth out rough edges
have to the medical services they need,” said William G. Hamm, in the law, Mr. Whitehurst notes.
PhD, a California economics consultant who coauthored the TAPA “We have conversations with the trial bar to see if there are areas
report. California’s $250,000 cap on noneconomic damages, passed [to improve]. We really utilize the attorneys with TMLT and some
in 1975, served as the model for Texas’ tort reform. of the other medical liability carriers to identify if we have problems,
Preserving that access is a continuing battle. Liability reform and [if] the trial bar has similar types of problems, whether we can
passed over the opposition of trial lawyers. Unsurprisingly, since work on some language that makes sense.
2003, plaintiff attorneys have fought the law both in the courthouse “But bottom line is that tort reform has achieved what it was in-
and at the Capitol. But efforts to weaken it legislatively have failed, tended to achieve, which was to improve access to care for services
and it has withstood numerous court challenges as well, even re- in communities that weren’t being served in the past.”
cently. (See “Protections Preserved,” July 2018 Texas Medicine, pages 34- Dr. Cardenas says the advocacy medicine used 15 years ago can
35, www.texmed.org/protectionspreserved, and “The Right be a blueprint for future initiatives that require a united front. He
Standard?” October 2016 Texas Medicine, pages 47-51, fondly remembers the work that brought to an end that once-dark
www.texmed.com/rightstandard.) era: “The empowerment of physicians to be able to do what we
Under HB 4 the damages cap in wrongful-death cases was tied were told over and over again was impossible — that we’d have to
to inflation, set at $500,000 in 1977 dollars. The legislature decided rewrite the Constitution of Texas.
against indexing the noneconomic damages cap. “What we ended up with was what’s been declared some of the
TMA lobbyist Darren Whitehurst says TMA would oppose any best tort reform laws in the country,” he said. “It’s created the ability
attempt to index that cap, as one failed bill attempted last session. for us to recruit in our state and retain in our state the physicians
“We set it at a number that we felt was fair and provided some and talent that we need in different areas in our state — both rural
level of compensation but didn’t create a jackpot for the patient. and urban.”

16 San Antonio Medicine • January 2019