Doctors found migrating to states with caps on damages

Studies debated whether rising liability premiums led to defensive medicine and lower physician supply or simply mirrored growth in overall health care costs.

By Mike Norbut, AMNews staff. June 20, 2005.

Physicians have gravitated more toward states that have caps on noneconomic damages in medical liability lawsuits than states that do not, say recently published studies.

The reports, in the June 1 issue of the Journal of the American Medical Association and online May 31 in Health Affairs, found that while states generally saw an increase in doctors over the past decades, those that enacted reforms that limit physician liability had a higher growth rate.

According to the JAMA study, states with direct reforms saw physician supply grow 2.4% more than in those without reforms. The Health Affairs study concluded that caps meant an additional five physicians per 100,000 people three years after reforms were enacted.

The studies show that tort reform is working to protect patients' access to care, especially among high-risk specialties such as obstetrics and neurosurgery, said AMA Immediate Past President Donald J. Palmisano, MD.

Patients "want a doctor in their hour of need," Dr. Palmisano said. "Attorneys are so protective of their contingency fees, but it's all about access to care."

According to the Health Affairs study, the lower the cap, the more it positively affected physician supply, especially among some specialties. Rural counties in states with a $250,000 cap reported 5.4% more ob-gyns and 5.5% more surgeons than rural regions in states without the same liability protection.

"Thus, a federal cap set at $250,000 for noneconomic damages could have a beneficial impact on the supply of surgeons and ob-gyns in rural areas," the study concluded.