By KURT C. LANGE, MD.
Taos and Los Alamos
Most of us love New Mexico but we know it has its problems. In 2019, according to US News and World Report, New Mexico ranked 48 out of 50 states as a place to live. In addition, healthcare ranked #33, education #50, crime #47 and opportunity #49. I think it’s obvious that following the COVID epidemic, things haven’t improved for New Mexico. These are the things a state government should provide for its citizens, but it appears they are failing.
Being a long time physician practicing medicine in Texas and later moving to New Mexico to continue to practice, I think I have a unique perspective. My wife, a board certified Allergist, and I, a Gastroenterologist, came to live in Taos from Dallas in 2018. We loved the New Mexico expanse, the vistas, food, culture, mountains and the outdoor opportunities here. We were tired of the city life. We began our medical practice in Los Alamos at a slower pace. I became an employed physician at the hospital. We accepted a lower income for a lifestyle improvement.
We were immediately struck by the lack of medical providers and the poor access to healthcare in this state. A 2022 study demonstrated the New Mexico had lost 30% of its primary care provider in the last 4 years. The study also showed unusually large numbers of doctors were nearing or at retirement age. Recruiting new doctors?
A recent 2022 study of New Mexico residents/trainees found that only 20% planned to stay in this state.
In Dallas, there is a doctor on every corner and if the patient isn’t prioritized, they will go next door. It was imperative to treat our patients as the special folks they were.
In my present practice, so many of my patients complain that they call doctor’s offices time after time and leave messages only to never be called back. I’ve heard horror stories of prolonged waits to receive critical medical care.
I personally have great difficulties getting my patients referred to a specialist within 6 months. This tells me that doctors are too busy and offices are understaffed. We just don’t have enough healthcare providers.
My wife and I were always aware of the previous medical malpractice environment of New Mexico but this did not deter us. New Mexico had decent malpractice claim limits and also had a provider funded patient compensation fund to draw from it if needed. Well that has changed since 2021 when the New Mexico legislature passed Bill HB75, increasing medical malpractice caps tremendously and our Governor quickly signed it into law. This bill was strongly supported by the powerful New Mexico trial lawyer lobby. By the way, in Texas, medical malpractice caps are $250,000 and are part of the state constitution. In other words, this law can’t be changed unless a constitutional amendment is passed. This is a very difficult thing to do.
In contrast, New Mexico caps are presently $750,000 for private practice providers and $4,000,000 for providers, like me, who are representatives of a hospital or corporation. In this country and state about 70% of providers work for hospitals or corporations thus affected by the higher caps. The caps are set to increase $500,000 yearly until 2027 when caps reach $6,000,000. And to make matters worse, the emergency physician fund is insolvent. There is no money in the fund due to actuarial design.
So, given the state of medical care here after 2021, what are we facing? Very likely closures of practices, hospitals, endoscopy and surgical centers and of course migration of providers. Insurance companies strongly prefer outpatient centers for healthcare. They individually contract with insurance companies and have much less overhead, thus they are much less expensive and the savings is passed on to the patient.
What does this mean for New Mexican citizens? Worsening already poor access to medical care and physicians leaving to surrounding states. Can patients go to surrounding states for healthcare? Yes and no. Medicare and private insurance are generally accepted everywhere. But, well over half of New Mexicans are covered by NM state Medicaid. They are not allowed to cross state lines for care.
What does this mean personally for my wife and I? We are retiring from medical practice as of 12/31/2023. We have no choice. All our retirement savings are at risk by these malpractice claim caps. It’s just too much of a gamble despite our wish to continue to practice. It’s been a good 5 years but it’s time to go. And my medical care? I’ll continue to see my Internist in Los Alamos but will get most higher level of care in Texas.
It doesn’t have to happen this way. New Mexico’s state government can amend this this law and help New Mexicans but it looks bad. On March 3, an attempt to stall bill HB75 for 2 years was tabled in committee along party lines, with Democrats preventing the proposal from passing. I guess wealthy trial lawyers are more important to state legislators than quality healthcare.