Higher Liability Caps Would Hurt Access to Care

Testimony by Len Dingler, MD

The House Judiciary and Jurisprudence Committee
House Bill 719 

March 28, 2017

Good afternoon. My name is Len Dingler. I am a full-service physician in Nocona, Texas. I treat patients in the Nocona Medical Clinic and at the adjoining Nocona General Hospital, a 38-bed hospital. Additionally, I treat patients at two local nursing homes and at a clinic in neighboring Ryan, Okla.

Nocona has a population of 3,000 people, with another 2,000 living within our immediate service area. My two physician partners and I provide the majority of the medical care in Montague County.

Our patients range from newborns to the elderly. We treat common illnesses and perform a host of screenings from colonoscopies to upper gastrointestinal endoscopy. I also cover the emergency room (ER) at Nocona General.

I, my brother Chance, who is also a physician, and our other partner, Rusty West, cover the Nocona General Hospital emergency room 24/7.  The three of us alternate evenings and weekends so that our community has a physician in its ER. Sometimes we run out of our clinic in the middle of a patient visit to get to the ER because a medical emergency waits for no one.

We see victims of car and motorcycle accidents, heart attacks, and strokes; snakebite victims; and those injured on the job. And we do emergency baby deliveries.  I describe myself as a country doctor, and what I mean by that is “we do it all.” And unlike in Fort Worth and Dallas, we do it for our friends, family, and neighbors since we generally know the people we are treating. 

We are the doctors for our local high school’s and middle school’s sports teams. In fact, I serve on the school board. My partners and I put in a full day. I work hard, and I love being a part of our small community. 

Preserving the noneconomic cap is critical to protecting access to care in my community. I know that because had tort reform not passed in 2003, and if liability rates had continued to rise, I would have had to leave Nocona and look for a job with a health care system in an urban area that would have paid those costs. If this bill passes and those costs do what they did prior to tort reform, I probably won’t leave Nocona to work someplace. I’ll just retire. 

I am concerned about the future of medical care in our community, and many, many others like it in Texas. Physicians in rural areas already work harder and make less money due to cuts in payment. I’m age 55. Our eldest physician, Rusty West, is 58. It’s always been difficult to recruit doctors to come to a rural community. But I am convinced that it will be even harder to recruit if the cap is raised and insurance premiums go back up again. 

There is a point when the practice of medicine in rural Texas becomes economically unsustainable. Raising the cap on damages moves us to that point as the increased cost can’t be passed on to our patients, many of whom are on Medicare and Medicaid.

 I understand that setting a noneconomic cap is a difficult decision. It requires finding a balance between appropriately compensating claimants and maintaining access to care.

However, please recognize that raising the cap on noneconomic damages would place a heavy burden on rural doctors as well as the rural hospitals where we treat patients. Both are ill-equipped to absorb the steadily rising liability costs that come with a steadily rising noneconomic damage cap. 

For that reason, I respectfully urge that you vote no on House Bill 719.

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Last Updated On

April 04, 2017