After Nearly 7 Years of Torturous “Tort Reforms,” Rural Texans Ask: Where are the Docs?

If you obliterate patients’ rights, they will come (the doctors, that is).  And if you don’t, they’ll leave.  So goes the oft-repeated promise – and threat – of the insurance industry and medical lobbies.  We’re all too familiar with how the “access to care” issue tends to be discussed – couched in hyped-up fear-mongering, not facts. “Who Will Deliver Your Baby?” said the scary, glossy Texas brochure in 2003, with industry arguing that the only way to solve doctor shortages in rural Texas was for patients to relinquish their constitutional rights – which they proceeded to do. 

But facts are stubborn things, as the Texas Observer first pointed out in 2007.  No, the docs were not coming back to these areas.  Not that anyone should be surprised, given the wealth of evidence showing why not.  But that hasn’t stopped politicians from continuing to mislead the public about what happened in Texas, repeating the myth the doctors have returned to underserved areas now that everyone’s legal rights have been stripped away.  

But here come those stubborn facts again!  According to a recent analysis of Texas Medical Board data in the Fort Worth Star-Telegram, “[t]he number of new doctors in family practice, the area most in demand, has increased by only about 200 [since 2003], about 16 percent, and more than 130 counties still did not have an obstetrician or gynecologist as of October [2009].”  Meanwhile, of the new doctors who have chosen to settle in Texas since 2003, more than half have chosen to “settle in the state’s largest urban areas, not in rural areas, where the shortage has been most apparent.”  And twenty-two Texas counties have no doctor at all.

Similarly, the New York Times reported yesterday that in Texas, “180 counties do not have enough physicians, 70 percent of patients cannot obtain a same-day visit with their primary care doctor, and 79 percent of emergency room visits are for routine problems.” 

Ultimately, as Alex Winslow, executive director of Texas Watch, observed: "Consumers [in Texas] are much worse off today….Not only have they not seen the benefits they were promised in healthcare, but now they’ve lost the ability to hold someone accountable. I think that puts patients at greater risk."