Alabama’s medical liability climate is giving physicians reasons to practice elsewhere and putting patients’ access to care at risk, Nina Ford Johnson, MD, argued in a Nov. 11 op-ed published by Yellowhammer News.
Dr. Johnson, a Mobile pediatrician and president of the Medical Association of the State of Alabama, framed the issue around services disappearing from communities. Monroe County Hospital closed its labor and delivery unit in 2023, she wrote, and hospitals from Grove Hill to Shelby County to Mobile have done the same in recent years. She acknowledged those closures stem from several factors, including financial pressures and staffing challenges, but said they illustrate a broader access problem facing the state.
“There is no single reason for Alabama’s healthcare access challenges. But one is Alabama’s medical liability climate, where physicians and medical practices face the possibility of extraordinarily large malpractice verdicts,” Dr. Johnson wrote.
Her central example is a case from earlier this year, in which a Mobile County jury returned a $50 million verdict against a cardiologist and his practice following a patient’s death. The award was later reduced to $6 million. The practice also provides care in rural Washington County, a medically underserved area where access to specialists is already limited, and information presented during the case showed the financial exposure threatened the practice’s future, according to Dr. Johnson. Physicians considered leaving or retiring, and investments in medical equipment were put on hold.
In reducing the verdict, the judge found credible evidence that the practice could lose several physicians and warned of serious consequences for care in Mobile and the surrounding region, Dr. Johnson wrote. He also weighed the potential impact on patients, whom he described as innocent third parties.
Dr. Johnson was careful to separate her argument from the question of accountability for medical errors.
“Patients and families who suffer harm deserve accountability. Nothing about improving Alabama’s medical liability environment should diminish the importance of patient safety or the responsibility physicians have to those entrusted to their care,” she wrote.
Her concern is with recruitment and retention. Alabama already struggles to compete for physicians because of inadequate reimbursement, heavy administrative requirements and insurance-related obstacles, she wrote, and the liability environment compounds those disadvantages for a physician finishing residency with substantial educational debt and deciding where to build a career.
“Why choose Alabama if practicing medicine here means confronting extraordinary liability risks, particularly when other states offer a more predictable environment?” Dr. Johnson wrote.
She pointed to Texas as a model. The state faced a serious physician recruitment and retention problem before adopting medical liability reforms in 2003, which included a $250,000 cap on noneconomic damages against physicians. Dr. Johnson wrote that Texas saw substantial growth in its physician workforce in the years that followed, including specialists practicing in underserved communities.
She called on state leaders to take up the issue, arguing that access to care is not a partisan matter.
“Legal reform is not about protecting doctors from accountability. It is about protecting patients’ access to doctors,” she wrote.
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