Lawmakers Push for Changes to Hospital Hiring Law

The House County Affairs Committee today heard heated testimony on a number of bills targeting hospitals' ability to hire physicians.

Currently, law does not allow hospitals to hire doctors directly. Instead, doctors must set up an individual practice.

Lawmakers laid out a number of different bills that would remove the corporate practice law from individual hospital districts, citing the need for doctors in rural areas in Texas. State Rep. Garnet Coleman's House Bill 1700, for instance, would allow hospitals in counties with a population of 50,000 or less to hire physicians.

Supporters of the current law say it keeps doctors' medical judgment free of interference from the hospital, which have to worry about their bottom lines. Dr. Susan Strate, representing the Texas Medical Association, said that without some safeguards, hospitals would have too much influence over doctors they hire. “The issue that we are talking about is if the physician becomes employed by another entity, there is a conflict of interest between that entity and that patient,” she said.

But Rep. Rick Hardcastle, R-Vernon, who introduced bills that would allow the Knox County Hospital District and the Hardeman County Hospital District to employ doctors, said the change was necessary because doctors in his district were getting older and the hospitals were having a hard time recruiting young doctors to a remote area. “This is about access to health care in rural Texas, where it is hard to attract physicians,” he said.

Last year, The Texas Tribune reported that 27 counties in Texas have no primary care physicians and that 16 have just one.

Although the TMA has historically been opposed to any changes to the corporate practice law, Strate testified neutrally on Hardcastle’s bill because it included wording that listed provisions that would, Strate said, protect a doctor’s individual medical judgment.

Those provisions provided, among other things, for the hospital board to appoint a chief medical officer and to adopt policies that ensure that a physician employed by the hospital exercises independent medical judgment in providing care to patients, Strate said.

Last session, a similar bill that would have allowed rural hospitals to hire physicians made its way to the governor’s desk but was vetoed because of tort language that was added to the bill.

At one point during the debate today, Coleman, D-Houston, accused Strate of trying to derail his bill by bringing up tort reform. That issue led Coleman to say that the TMA was being disingenuous and was simply looking for a way to stop what he called necessary changes.

Strate said the TMA was not looking to derail the bill or to bring up tort reform. Instead, she said, the TMA was simply trying to ensure physicians give their patients the best possible care without interference.

“I think we are very close to getting a bill that we can be confident in that represents the interest of Texas physicians,” Strate said.

For his part, Coleman said he felt confident that there was enough support for the bill that it would once again reach the governor’s desk.