TMA Priority: Preserve Texas’ landmark 2003 tort reforms, which continue to undergird a strong Texas physician workforce.
Recap: For the 20th year in a row, the Texas Medical Association successfully defended the state’s medical liability reforms, the centerpiece of which is a $250,000 constitutional cap on non-economic damages in medical negligence lawsuits against individual physicians.
In addition to foiling several bills that would have increased physicians’ liability exposure, TMA championed legislation that strengthens the Texas Medical Board (TMB) with funding for additional staff – necessary to maintain oversight of physicians and to accommodate the influx of medical license applicants from other states. These interconnected goals were among the association’s top legislative priorities this session.
On the liability front, TMA squashed the perennial attempt to index the state’s $250,000 constitutional cap to inflation. House Bill 536 by Rep. Gene Wu (D-Houston) died in committee during the early months of session.
TMA also kept at bay several novel liability threats.
Topping that list, Senate Bill 177 would have redefined the current legal framework for informed consent vis-à-vis COVID-19 vaccine mandates. If a patient were coerced by a third party to get the vaccine, physicians who administered the shot, however unknowingly, could have been financially liable for the conduct of that third party.
And although Senate Bill 29 by Sen. Brian Birdwell (R-Granbury) ultimately passed to prohibit state and local governments from issuing COVID-19 mask or vaccine mandates, TMA worked with Senator Birdwell’s office help ensure it excluded private businesses and health care entities – and ward off potential lawsuits.
TMA President-Elect Ray Callas, MD, an anesthesiologist in Beaumont, says these wins are critical for maintaining Texas’ medicine-friendly reputation.
“We did not have any erosion of medical liability reform or tort reform,” he told Texas Medicine Today. “That’s what keeps driving physicians into the state of Texas.”
TMA also successfully advocated for a stronger medical board, which plays an important role in maintaining the state’s landmark 2003 tort reforms, says Zachary Jones, MD, an anesthesiologist in Frisco who serves on TMA’s Council on Legislation.
“Having a strong medical board that’s able to protect Texans from substandard care ensures that the legal process is not required to protect patients,” he said. “As soon as Texans feel unprotected by the medical board, their only resort is a lawsuit.”
The 2024-25 state budget includes an additional $5 million for TMB, which will allow the state agency to grow its staff by 30 full-time employees.
Jimmy Widmer, MD, an internist in Belton and TMA Council on Legislation member, says this is a necessary expansion given Texas’ explosive population growth in recent years.
“The potential for a bottleneck [in physician] licensure not only impacts somebody who’s trying to come into the state of Texas to practice medicine … but it’s also a patient care issue,” he said. “A robust medical board … is critical to being able to take care of Texans and meet the demand of the influx of patients.”
TMA also fended off two bills that threatened TMB’s authority:
- Senate Bill 161 and its companion House Bill 724 – which TMA Council on Legislation Chair Tilden Childs, MD, testified in opposition to – would have prevented TMB from issuing cease-and-desist letters to nonphysician practitioners who venture into the practice of medicine; and
- Senate Bill 666 by Sen. Bob Hall (R-Edgewood) would have restricted TMB’s complaint process, weakened its disciplinary authority, and increased its operating costs.
Meanwhile, through a multi-stakeholder collaborative effort, TMA helped secure a hard-fought win in another area of potential liability that comes up every session: end-of-life care. The association won compromise legislation in House Bill 3162 by Rep. Stephanie Klick (R-Fort Worth), which protects the state’s existing statute governing do-not-attempt-resuscitation (DNAR) orders and includes DNAR process and liability reforms for physicians. Gov. Greg Abbott signed the bill into law in mid-June.
The long hours and detailed negotiations that went into developing the legislation hopefully will prevent recurring end-of-life battles from resurfacing in future sessions, says Mark Casanova, MD. The Dallas palliative care specialist and member of TMA’s Council on Health Service Organizations participated in the talks, which involved hospital, physician, religious, and right-to-life groups.
For more information, check out TMA’s state advocacy webpage.