Thursday, December 20, 2007
Overlawyered today did a post about stories that shouldn't get away, and noted my discussion about the data regarding what has happened since Texas implemented changes in malpractice liability law in 2003. That reminded me that I had in fact let that issue get away, even though I have some more data to share.
As a refresher, the NYT had an article noting a correlation between the 2003 changes and an increase in doctor supply in Texas. It raises various interesting questions about cause-and-effect (and Tony Sebok argues that it's more fundamentally flawed). One response was to note, as Eric Turkewitz did, that disciplinary proceedings are up fairly significantly in the same time period, suggesting that perhaps that the changes brought more doctors to the state, but not the ones you want. It's also possible that the increase in discipline resulted from more intense scrutiny by the state regulators.
At the time, I did a quick look at the most recent quality of care violations and found no disproportionate number of new doctors in the mix (which, if the 2003 changes were to blame, you'd expect). Since then, my research assistant went through all of the August 2007 disciplinary actions (not just those for quality of care, as I did before). The spreadsheet is here: Download TexasDoctors.xls
Of the 87 or so (there are a couple of ambiguous ones) actions against physicians with licenses, five are from the period from 2003 to 2007 (six if you count the "temporary permit, which I wouldn't since one would expect someone coming to take advantage of the new law to stick around). That's about 6%.
If I'm reading the various stats on the medical board's website right, there are about 58,000 Texas-licensed doctors (some out of state). In the years 2003 through 2007, there were just over 13,000 doctors licensed in Texas. So about 22% of doctors licensed in Texas were licensed from 2003 to 2007. 22 > 6.
Now, there may be some apples and oranges there, and the sample is still small -- and I still hope to get my assistant to do a more comprehensive look -- but it does not, at this point, look like the doctors licensed since the liability modifications represent a greater than expected proportion of disciplinary actions. Indeed, thus far, in one month's sample, it looks like the contrary may be the case.