Legislative Priority #5: Protect Tort Reform
By Alisa Pierce


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Goal: Preserve Texas’ landmark 2003 medical liability reforms, which continue to undergird a strong Texas physician workforce.

Impact: This year will mark 20 years since a broad coalition of Texas physicians led the successful effort to achieve medical liability reform in Texas.

Given the turnover in the legislature, however, there only a handful of lawmakers still serving in the House were there for that historic vote, the centerpiece of which is a $250,000 constitutional cap on non-economic damages in medical negligence lawsuits against individual physicians.  (A maximum of $750,000 is allowed if health care institutions are also found liable.)

And in light of California’s and New York’s recent success in tying their caps to inflation, TMA’s work becomes even more important to fend off such efforts in Texas and convey to lawmakers what a linchpin tort reform has been in attracting physicians to practice in Texas in record numbers, says TMA lobbyist Michelle Romero.

Edinburg internist Linda Villarreal, MD, remembers what it was like providing care in Texas before medical liability reforms.

“It was just a different world,” Dr. Villarreal, who previously served as Texas Medical Association (TMA) president said. “The miracle of time was not available to us, and a lot of our very sick patients had to be transferred up to 300 miles away.”

To this day, she remembers vividly one of those patients who had to be flown to Houston for treatment for a brain aneurysm. Since her area lacked neurosurgeons, the patient couldn’t be treated quickly enough and died.

Before 2003, there were no caps in place to reduce the number or severity of negligence lawsuits, no matter how frivolous. For physicians, that translated to sky-high medical liability insurance costs; for rural patients especially, it meant a lack of specialty care because doctors could not afford to practice, or they feared doing so could invite career-ending lawsuits.

Dr. Villarreal says the need for reform was dire. So, she and other Texas physicians led the charge to achieve that goal.

“So many high-risk sub-specialties just did not come to our area to set up a practice,” she said. “So, we made our colleagues and the rest of Texas fully aware of our plight, and it was through a united front, and through TMA, that we as physicians were able to support and encourage this legislation. That's why it passed.”

Since then, the Valley has seen monumental changes that, if applied at the time, Dr. Villarreal’s believes could’ve saved her patient. “Tort reform really, really brought good care to all our patients along the border.”

In fact, since 2003, Texas hit multiple records for newly licensed physicians, tripling the number between 2003 and 2022 from about 2,000 to more than 7,000, according to Texas Medical Board data.

Dr. Villarreal fears that that many have forgotten the importance of Texas’ liability protections, which TMA has built upon over the years to extend to disasters and public health emergencies.  

“Sometimes we must remind individuals, whether they're legislators, medical students, residents, or physicians who are about to retire, about these stories,” she said. “The new class of medical students don’t know what it was like. Every single physician at one point or another has had to refer a patient to a specialist sooner rather than later, which is why we need to protect tort reform.”

Last Updated On

January 06, 2023

Originally Published On

December 21, 2022

Alisa Pierce

Reporter, Division of Communications and Marketing

(512) 370-1469
Alisa Pierce

Alisa Pierce is a reporter for Texas Medicine. After graduating from Texas State University, she worked in local news, covering state politics, public health, and education. Alongside her news writing, Alisa covered up-and-coming artists in Central Texas and abroad as a music journalist. As a Texas native, she enjoys capturing the landscape on her film camera while hiking her way across the Lonestar State.

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