OPINION: The real root of New Mexico's doctor shortage

The discussion regarding New Mexico’s doctor shortage has been centered on a single myth: Medical malpractice reform will increase the number of doctors. The outcome of this debate will affect every patient in New Mexico because corporate medicine wants to restrict a patient’s rights to recover damages if harmed by hedge fund medicine. Yet, hedge fund medicine wants an unrestricted ability to sue a patient for any bills. The same Bill of Rights that gives patients the right to free speech and to carry guns also gives patients a right to have a jury — not corporate medicine — decide if the patient was injured through malpractice.

There are not enough medical providers in New Mexico and that is true for most of the U.S. In 2023, New Mexico had 256 physicians for every 100,000 residents. Not great, but we had more physicians than Texas (238), Arizona (254), and Idaho (193). Idaho and Texas also have some of the most draconian medical malpractice caps in the country yet less doctors than New Mexico. Arizona (254) and Minnesota (329), with their famous clinics, have no limits on the amount of compensatory damages a patient can seek for medical malpractice. In 2024, New Mexico increased the number of doctors with 290 and Texas fell below New Mexico to only 225-230 doctors per capita. If Arizona and Minnesota are the examples (they have good docs and more of them), then perhaps New Mexico should eliminate our medical malpractice caps.

The root cause of the U.S.’s (it is not limited to New Mexico) physician shortage was a moratorium created by the American Medical Association (AMA) and Congress with the Balanced Budget Act of 1997. Concerned about a surplus of doctors (lowered income), the AMA created a moratorium of new medical schools, required reduced enrollment and froze medical class sizes from 1980 through 2005. Then, the 1997 Act froze funding for residency slots to 1996 levels. Our population increased yet we created fewer doctors in 1989 than we did in 1981. Currently, there are 9,000 medical students who are unable to complete training because there are not enough residency slots available. With the great retirement, there were not enough doctors created to fill in their spots. The problem suggests the solution: create more doctors by funding residency slots at the University of New Mexico to train more doctors.

There is one change to our medical system that has increased providers liability insurance rates: private hospitals’ admissions to New Mexico’s Malpractice Act. Since 1976, the act protected independent doctors, but hospitals were not part of the act. In the early 2010s, St. Vincent (ultimately purchased by private equity) was admitted under the act. Other hospitals followed. But the state’s insurance superintendent did not charge the hospitals enough to join. By 2020, the hospitals, with their low premiums, essentially bankrupted the system. Patient advocates sought to eliminate hospitals from the act to protect doctors and patients. The New Mexico Hospital Association refused and a compromise was struck with the association (representing hospitals), medical society (representing doctors), and patient advocates to keep hospitals in the act, but to charge more to protect the medical malpractice fund.

The result was liability insurance for doctors rose significantly. OB/GYNs, for example, have some of the highest premiums of any specialty when compared to Arizona. Other specialties’ premiums, however, are not as high, New Mexico gastroenterology doctors testified their rates are $27,850 per year. Eliminating hospitals from the act would restore the lower insurance rates. Arizona’s providers have lower insurance rates. The difference? New Mexico has the Med Mal Act. Arizona keeps providers’ insurance rates low through free markets without the need for big government action.