Publisher’s Note: A State of Change

February 1, 2007

Texas physicians worked hard to improve the state’s practice climate. Will you follow their example?


A few years ago I found myself locked out of the local branch of my bank, even though it was midday. A sign on the door explained, as only a corporate spinmeister can: “For your convenience, this branch has been closed.”

Not all change is for the best. Still, a great deal of it is needed in American healthcare, and most of the positive changes that have been made in the last few years have occurred at the state level.

Take Texas, for example.

The last time we published our analysis of America’s physician-friendliest states in 2005, the Lone Star State was disqualified from consideration because its malpractice climate was “in crisis,” as that term is defined by the AMA.

Imagine our surprise, then, when it made our 2007 elite listing, published in this issue. Over the last several years, Texas physicians have been working together to improve their practice environment with changes to state laws and even the Texas constitution. Those changes, while protested by so-called consumer advocates, ushered in a new, more positive legal landscape for physicians. Texas physicians say the malpractice climate in their state, which only recently was one of the worst in the country, is fast improving.

Physician recruiting experts say more physicians than ever are on the move, including - if not especially - mid-career physicians finally fed up with intolerable working conditions and reimbursement that’s too low for their areas. Still, we don’t expect doctors living in, say, New London, Conn., to pack up and move to Paris, Texas, simply because they’ve read our story.

But we do hope that those of you who find yourselves in the same position Texas physicians were in two years ago will respond in the same way. They banded together, made use of their state and local medical societies to demand change, and talked to patients individually, one voter at a time, about the plight that they - doctors and patients both - were in.

There’s no reason you can’t do the same.

While that might sound Pollyannaish, 2007 offers one of the best opportunities for creating a better practice environment in recent memory.

In many of the less-friendly states, governors and legislative leaders have listed healthcare reform as a top priority. That creates an opportunity for changes in those states.

With Democrats taking control of Congress, federal malpractice reform is probably dead. Still, Democratic leaders may be giving second thought to the physician reimbursement reductions, postponed for another year by Congress in late December, but slated again for January 2008. One line of thinking is to replace the hodgepodge approach with a more comprehensive solution to the nation’s healthcare dilemma. That would affect many of the factors considered in this year’s Physicians Practice analysis, including reimbursement, reimbursement margins, and maybe even the rising cost of living.

While that may be a tall order before the 2008 presidential election, in 2005 few Texas physicians ever thought that positive change could happen to them.

What do you think? Can physicians working together really affect change? E-mail me at kkarpay@physicianspractice.com.
This article originally appeared in the February 2007 issue of
Physicians Practice.