Mary Ellen Schneider

The issue of medical liability reform is back in the headlines since President Obama said he would consider some type of reform to curb frivolous lawsuits. But physicians say there are plenty of political obstacles to making meaningful changes to the tort system.

One of the major hurdles, according to Texas Medical Association president Susan Rudd Bailey, will be getting a bill passed by the Democratic-controlled Senate. Democrats have historically opposed capping noneconomic damages, otherwise known as pain and suffering awards, which have been at the heart of the tort reforms passed in Texas and California.

"This is no slam dunk," said Dr. Bailey, an allergist in Fort Worth.

The Texas Medical Association is one of more than 100 state and national medical organizations that have endorsed new federal legislation aimed at reducing medical liability lawsuits. The Help Efficient, Accessible, Low-Cost, Timely Healthcare (HEALTH) Act, H.R. 5, is modeled after California's Medical Injury Compensation Reform Act (MICRA), which has been in place for about 30 years. The new federal legislation would place a $250,000 cap on noneconomic damages and would require that medical liability suits must be filed within 3 years of the injury in most cases.

The cap on noneconomic damages is the cornerstone of the Texas medical liability reform law enacted in 2003. The cap, Dr. Bailey said, has helped to reduce premiums and improve access for patients. For example, 90% of the state's physicians have seen their malpractice insurance rates cut by 30% or more, according to the Texas Medical Association.

In 2001– before the legislation was enacted – the number of newly licensed physicians in Texas was at a decade-long low of 2,088. By 2008, that number had risen to 3,621. And since enactment, the number of physicians practicing in previously scare specialties including obstetrics, orthopedic surgery, neurosurgery, emergency medicine, and cardiovascular surgery has increased, according to figures from the Texas Medical Association.

So far, the President has been light on specifics. In 2009, as Congress was considering the Affordable Care Act, the President told the American Medical Association that he did not favor capping noneconomic damages because it can be unfair to patients.

The AMA has been pushing to get medical liability reform back at the top of the congressional agenda after it was left out of the ACA.

Dr. Ardis Dee Hoven, AMA chairwoman, recently testified before the House Judiciary Committee about the pressure physicians face from malpractice suits.

An AMA survey found that 61% of physicians age 55 and older had been sued at least once in their careers, with an average of 1.6 claims per doctor. But certain specialties, like obstetrics-gynecology and surgery, had much higher rates.

Many of the lawsuits are without merit, Dr. Hoven testified to the committee. The AMA survey found that 65% of claims were dropped, dismissed, or withdrawn. But it still cost about $20,000 per claim to defend the suits that were ultimately dropped, according to the report.

The American College of Physicians, which also supports the HEALTH Act, is calling on Congress to consider other reforms to reduce defensive medicine, such as health courts. The ACP is asking Congress to pass legislation that would allow for pilot testing of health courts on a national scale.

Health courts are a no-fault system in which cases are heard by specially trained judges with access to independent medical experts. Health court judges would be able to authorize awards based on the damages incurred.

The issue of medical liability reform is back in the headlines since President Obama said he would consider some type of reform to curb frivolous lawsuits. But physicians say there are plenty of political obstacles to making meaningful changes to the tort system.

One of the major hurdles, according to Texas Medical Association president Susan Rudd Bailey, will be getting a bill passed by the Democratic-controlled Senate. Democrats have historically opposed capping noneconomic damages, otherwise known as pain and suffering awards, which have been at the heart of the tort reforms passed in Texas and California.

"This is no slam dunk," said Dr. Bailey, an allergist in Fort Worth.

The Texas Medical Association is one of more than 100 state and national medical organizations that have endorsed new federal legislation aimed at reducing medical liability lawsuits. The Help Efficient, Accessible, Low-Cost, Timely Healthcare (HEALTH) Act, H.R. 5, is modeled after California's Medical Injury Compensation Reform Act (MICRA), which has been in place for about 30 years. The new federal legislation would place a $250,000 cap on noneconomic damages and would require that medical liability suits must be filed within 3 years of the injury in most cases.

The cap on noneconomic damages is the cornerstone of the Texas medical liability reform law enacted in 2003. The cap, Dr. Bailey said, has helped to reduce premiums and improve access for patients. For example, 90% of the state's physicians have seen their malpractice insurance rates cut by 30% or more, according to the Texas Medical Association.

In 2001– before the legislation was enacted – the number of newly licensed physicians in Texas was at a decade-long low of 2,088. By 2008, that number had risen to 3,621. And since enactment, the number of physicians practicing in previously scare specialties including obstetrics, orthopedic surgery, neurosurgery, emergency medicine, and cardiovascular surgery has increased, according to figures from the Texas Medical Association.

So far, the President has been light on specifics. In 2009, as Congress was considering the Affordable Care Act, the President told the American Medical Association that he did not favor capping noneconomic damages because it can be unfair to patients.

The AMA has been pushing to get medical liability reform back at the top of the congressional agenda after it was left out of the ACA.

Dr. Ardis Dee Hoven, AMA chairwoman, recently testified before the House Judiciary Committee about the pressure physicians face from malpractice suits.

An AMA survey found that 61% of physicians age 55 and older had been sued at least once in their careers, with an average of 1.6 claims per doctor. But certain specialties, like obstetrics-gynecology and surgery, had much higher rates.

Many of the lawsuits are without merit, Dr. Hoven testified to the committee. The AMA survey found that 65% of claims were dropped, dismissed, or withdrawn. But it still cost about $20,000 per claim to defend the suits that were ultimately dropped, according to the report.

The American College of Physicians, which also supports the HEALTH Act, is calling on Congress to consider other reforms to reduce defensive medicine, such as health courts. The ACP is asking Congress to pass legislation that would allow for pilot testing of health courts on a national scale.

Health courts are a no-fault system in which cases are heard by specially trained judges with access to independent medical experts. Health court judges would be able to authorize awards based on the damages incurred.

The issue of medical liability reform is back in the headlines since President Obama said he would consider some type of reform to curb frivolous lawsuits. But physicians say there are plenty of political obstacles to making meaningful changes to the tort system.

One of the major hurdles, according to Texas Medical Association president Susan Rudd Bailey, will be getting a bill passed by the Democratic-controlled Senate. Democrats have historically opposed capping noneconomic damages, otherwise known as pain and suffering awards, which have been at the heart of the tort reforms passed in Texas and California.

"This is no slam dunk," said Dr. Bailey, an allergist in Fort Worth.

The Texas Medical Association is one of more than 100 state and national medical organizations that have endorsed new federal legislation aimed at reducing medical liability lawsuits. The Help Efficient, Accessible, Low-Cost, Timely Healthcare (HEALTH) Act, H.R. 5, is modeled after California's Medical Injury Compensation Reform Act (MICRA), which has been in place for about 30 years. The new federal legislation would place a $250,000 cap on noneconomic damages and would require that medical liability suits must be filed within 3 years of the injury in most cases.

The cap on noneconomic damages is the cornerstone of the Texas medical liability reform law enacted in 2003. The cap, Dr. Bailey said, has helped to reduce premiums and improve access for patients. For example, 90% of the state's physicians have seen their malpractice insurance rates cut by 30% or more, according to the Texas Medical Association.

In 2001– before the legislation was enacted – the number of newly licensed physicians in Texas was at a decade-long low of 2,088. By 2008, that number had risen to 3,621. And since enactment, the number of physicians practicing in previously scare specialties including obstetrics, orthopedic surgery, neurosurgery, emergency medicine, and cardiovascular surgery has increased, according to figures from the Texas Medical Association.

So far, the President has been light on specifics. In 2009, as Congress was considering the Affordable Care Act, the President told the American Medical Association that he did not favor capping noneconomic damages because it can be unfair to patients.

The AMA has been pushing to get medical liability reform back at the top of the congressional agenda after it was left out of the ACA.

Dr. Ardis Dee Hoven, AMA chairwoman, recently testified before the House Judiciary Committee about the pressure physicians face from malpractice suits.

An AMA survey found that 61% of physicians age 55 and older had been sued at least once in their careers, with an average of 1.6 claims per doctor. But certain specialties, like obstetrics-gynecology and surgery, had much higher rates.

Many of the lawsuits are without merit, Dr. Hoven testified to the committee. The AMA survey found that 65% of claims were dropped, dismissed, or withdrawn. But it still cost about $20,000 per claim to defend the suits that were ultimately dropped, according to the report.

The American College of Physicians, which also supports the HEALTH Act, is calling on Congress to consider other reforms to reduce defensive medicine, such as health courts. The ACP is asking Congress to pass legislation that would allow for pilot testing of health courts on a national scale.

Health courts are a no-fault system in which cases are heard by specially trained judges with access to independent medical experts. Health court judges would be able to authorize awards based on the damages incurred.

The issue of medical liability reform is back in the headlines since President Obama said he would consider some type of reform to curb frivolous lawsuits. But physicians say there are plenty of political obstacles to making meaningful changes to the tort system.

One of the major hurdles, according to Texas Medical Association president Susan Rudd Bailey, will be getting a bill passed by the Democratic-controlled Senate. Democrats have historically opposed capping noneconomic damages, otherwise known as pain and suffering awards, which have been at the heart of the tort reforms passed in Texas and California.

"This is no slam dunk," said Dr. Bailey, an allergist in Fort Worth.

The Texas Medical Association is one of more than 100 state and national medical organizations that have endorsed new federal legislation aimed at reducing medical liability lawsuits. The Help Efficient, Accessible, Low-Cost, Timely Healthcare (HEALTH) Act, H.R. 5, is modeled after California’s Medical Injury Compensation Reform Act (MICRA), which has been in place for about 30 years. The new federal legislation would place a $250,000 cap on noneconomic damages and would require that medical liability suits must be filed within 3 years of the injury in most cases.

The cap on noneconomic damages is the cornerstone of the Texas medical liability reform law enacted in 2003. The cap, Dr. Bailey said, has helped to reduce premiums and improve access for patients. For example, 90% of the state’s physicians have seen their malpractice insurance rates cut by 30% or more, according to the Texas Medical Association.

In 2001– before the legislation was enacted – the number of newly licensed physicians in Texas was at a decade-long low of 2,088. By 2008, that number had risen to 3,621. And since enactment, the number of physicians practicing in previously scare specialties including obstetrics, orthopedic surgy, neurosurgery, emergency medicine, and cardiovascular surgery has increased, according to figures from the Texas Medical Association.

Dr. Alex Valadka, a neurosurgeon at the Seton Brain and Spine Institute in Austin, said the 2003 tort law has dramatically improved the practice climate in the state. Anecdotally, Dr. Valadka says he’s getting fewer calls from other physicians seeking consultations on complicated cases because there are more neurosurgeons to take on the work. Dr. Valadka said he hopes that similar reforms can be passed at the federal level, but he said he’s doubtful that President Obama’s vision for tort reform will look like the Texas statute.

So far, the President has been light on specifics. In 2009, as Congress was considering the Affordable Care Act, the President told the American Medical Association that he did not favor capping noneconomic damages because it can be unfair to patients.

The AMA has been pushing to get medical liability reform back at the top of the congressional agenda after it was left out of the ACA.

Dr. Ardis Dee Hoven, AMA chairwoman, recently testified before the House Judiciary Committee about the pressure physicians face from malpractice suits.

An AMA survey found that 61% of physicians age 55 and older had been sued at least once in their careers, with an average of 1.6 claims per doctor. But certain specialties, like obstetrics-gynecology and surgery, had much higher rates.

Many of the lawsuits are without merit, Dr. Hoven testified to the committee. The AMA survey found that 65% of claims were dropped, dismissed, or withdrawn. But it still cost about $20,000 per claim to defend the suits that were ultimately dropped, according to the report.

The American College of Physicians, which also supports the HEALTH Act, is calling on Congress to consider other reforms to reduce defensive medicine, such as health courts. The ACP is asking Congress to pass legislation that would allow for pilot testing of health courts on a national scale.

Health courts are a no-fault system in which cases are heard by specially trained judges with access to independent medical experts. Health court judges would be able to authorize awards based on the damages incurred.

The issue of medical liability reform is back in the headlines since President Obama said he would consider some type of reform to curb frivolous lawsuits. But physicians say there are plenty of political obstacles to making meaningful changes to the tort system.

One of the major hurdles, according to Texas Medical Association president Susan Rudd Bailey, will be getting a bill passed by the Democratic-controlled Senate. Democrats have historically opposed capping noneconomic damages, otherwise known as pain and suffering awards, which have been at the heart of the tort reforms passed in Texas and California.

"This is no slam dunk," said Dr. Bailey, an allergist in Fort Worth.

The Texas Medical Association is one of more than 100 state and national medical organizations that have endorsed new federal legislation aimed at reducing medical liability lawsuits. The Help Efficient, Accessible, Low-Cost, Timely Healthcare (HEALTH) Act, H.R. 5, is modeled after California’s Medical Injury Compensation Reform Act (MICRA), which has been in place for about 30 years. The new federal legislation would place a $250,000 cap on noneconomic damages and would require that medical liability suits must be filed within 3 years of the injury in most cases.

The cap on noneconomic damages is the cornerstone of the Texas medical liability reform law enacted in 2003. The cap, Dr. Bailey said, has helped to reduce premiums and improve access for patients. For example, 90% of the state’s physicians have seen their malpractice insurance rates cut by 30% or more, according to the Texas Medical Association.

In 2001– before the legislation was enacted – the number of newly licensed physicians in Texas was at a decade-long low of 2,088. By 2008, that number had risen to 3,621. And since enactment, the number of physicians practicing in previously scare specialties including obstetrics, orthopedic surgy, neurosurgery, emergency medicine, and cardiovascular surgery has increased, according to figures from the Texas Medical Association.

Dr. Alex Valadka, a neurosurgeon at the Seton Brain and Spine Institute in Austin, said the 2003 tort law has dramatically improved the practice climate in the state. Anecdotally, Dr. Valadka says he’s getting fewer calls from other physicians seeking consultations on complicated cases because there are more neurosurgeons to take on the work. Dr. Valadka said he hopes that similar reforms can be passed at the federal level, but he said he’s doubtful that President Obama’s vision for tort reform will look like the Texas statute.

So far, the President has been light on specifics. In 2009, as Congress was considering the Affordable Care Act, the President told the American Medical Association that he did not favor capping noneconomic damages because it can be unfair to patients.

The AMA has been pushing to get medical liability reform back at the top of the congressional agenda after it was left out of the ACA.

Dr. Ardis Dee Hoven, AMA chairwoman, recently testified before the House Judiciary Committee about the pressure physicians face from malpractice suits.

An AMA survey found that 61% of physicians age 55 and older had been sued at least once in their careers, with an average of 1.6 claims per doctor. But certain specialties, like obstetrics-gynecology and surgery, had much higher rates.

Many of the lawsuits are without merit, Dr. Hoven testified to the committee. The AMA survey found that 65% of claims were dropped, dismissed, or withdrawn. But it still cost about $20,000 per claim to defend the suits that were ultimately dropped, according to the report.

The American College of Physicians, which also supports the HEALTH Act, is calling on Congress to consider other reforms to reduce defensive medicine, such as health courts. The ACP is asking Congress to pass legislation that would allow for pilot testing of health courts on a national scale.

Health courts are a no-fault system in which cases are heard by specially trained judges with access to independent medical experts. Health court judges would be able to authorize awards based on the damages incurred.

The issue of medical liability reform is back in the headlines since President Obama said he would consider some type of reform to curb frivolous lawsuits. But physicians say there are plenty of political obstacles to making meaningful changes to the tort system.

One of the major hurdles, according to Texas Medical Association president Susan Rudd Bailey, will be getting a bill passed by the Democratic-controlled Senate. Democrats have historically opposed capping noneconomic damages, otherwise known as pain and suffering awards, which have been at the heart of the tort reforms passed in Texas and California.

"This is no slam dunk," said Dr. Bailey, an allergist in Fort Worth.

The Texas Medical Association is one of more than 100 state and national medical organizations that have endorsed new federal legislation aimed at reducing medical liability lawsuits. The Help Efficient, Accessible, Low-Cost, Timely Healthcare (HEALTH) Act, H.R. 5, is modeled after California’s Medical Injury Compensation Reform Act (MICRA), which has been in place for about 30 years. The new federal legislation would place a $250,000 cap on noneconomic damages and would require that medical liability suits must be filed within 3 years of the injury in most cases.

The cap on noneconomic damages is the cornerstone of the Texas medical liability reform law enacted in 2003. The cap, Dr. Bailey said, has helped to reduce premiums and improve access for patients. For example, 90% of the state’s physicians have seen their malpractice insurance rates cut by 30% or more, according to the Texas Medical Association.

In 2001– before the legislation was enacted – the number of newly licensed physicians in Texas was at a decade-long low of 2,088. By 2008, that number had risen to 3,621. And since enactment, the number of physicians practicing in previously scare specialties including obstetrics, orthopedic surgy, neurosurgery, emergency medicine, and cardiovascular surgery has increased, according to figures from the Texas Medical Association.

Dr. Alex Valadka, a neurosurgeon at the Seton Brain and Spine Institute in Austin, said the 2003 tort law has dramatically improved the practice climate in the state. Anecdotally, Dr. Valadka says he’s getting fewer calls from other physicians seeking consultations on complicated cases because there are more neurosurgeons to take on the work. Dr. Valadka said he hopes that similar reforms can be passed at the federal level, but he said he’s doubtful that President Obama’s vision for tort reform will look like the Texas statute.

So far, the President has been light on specifics. In 2009, as Congress was considering the Affordable Care Act, the President told the American Medical Association that he did not favor capping noneconomic damages because it can be unfair to patients.

The AMA has been pushing to get medical liability reform back at the top of the congressional agenda after it was left out of the ACA.

Dr. Ardis Dee Hoven, AMA chairwoman, recently testified before the House Judiciary Committee about the pressure physicians face from malpractice suits.

An AMA survey found that 61% of physicians age 55 and older had been sued at least once in their careers, with an average of 1.6 claims per doctor. But certain specialties, like obstetrics-gynecology and surgery, had much higher rates.

Many of the lawsuits are without merit, Dr. Hoven testified to the committee. The AMA survey found that 65% of claims were dropped, dismissed, or withdrawn. But it still cost about $20,000 per claim to defend the suits that were ultimately dropped, according to the report.

The American College of Physicians, which also supports the HEALTH Act, is calling on Congress to consider other reforms to reduce defensive medicine, such as health courts. The ACP is asking Congress to pass legislation that would allow for pilot testing of health courts on a national scale.

Health courts are a no-fault system in which cases are heard by specially trained judges with access to independent medical experts. Health court judges would be able to authorize awards based on the damages incurred.

The issue of medical liability reform is back in the headlines since President Obama said he would consider some type of reform to curb frivolous lawsuits. But physicians say there are plenty of political obstacles to making meaningful changes to the tort system.

One of the major hurdles, according to Texas Medical Association president Susan Rudd Bailey, will be getting a bill passed by the Democratic-controlled Senate. Democrats have historically opposed capping noneconomic damages, otherwise known as pain and suffering awards, which have been at the heart of the tort reforms passed in Texas and California.

"This is no slam dunk," said Dr. Bailey, an allergist in Fort Worth.

The Texas Medical Association is one of more than 100 state and national medical organizations that have endorsed new federal legislation aimed at reducing medical liability lawsuits. The Help Efficient, Accessible, Low-Cost, Timely Healthcare (HEALTH) Act, H.R. 5, is modeled after California’s Medical Injury Compensation Reform Act (MICRA), which has been in place for about 30 years. The new federal legislation would place a $250,000 cap on noneconomic damages and would require that medical liability suits must be filed within 3 years of the injury in most cases.

The cap on noneconomic damages is the cornerstone of the Texas medical liability reform law enacted in 2003. The cap, Dr. Bailey said, has helped to reduce premiums and improve access for patients. For example, 90% of the state’s physicians have seen their malpractice insurance rates cut by 30% or more, according to the Texas Medical Association.

In 2001– before the legislation was enacted – the number of newly licensed physicians in Texas was at a decade-long low of 2,088. By 2008, that number had risen to 3,621. And since enactment, the number of physicians practicing in previously scare specialties including obstetrics, orthopedic surgy, neurosurgery, emergency medicine, and cardiovascular surgery has increased, according to figures from the Texas Medical Association.

Dr. Alex Valadka, a neurosurgeon at the Seton Brain and Spine Institute in Austin, said the 2003 tort law has dramatically improved the practice climate in the state. Anecdotally, Dr. Valadka says he’s getting fewer calls from other physicians seeking consultations on complicated cases because there are more neurosurgeons to take on the work. Dr. Valadka said he hopes that similar reforms can be passed at the federal level, but he said he’s doubtful that President Obama’s vision for tort reform will look like the Texas statute.

So far, the President has been light on specifics. In 2009, as Congress was considering the Affordable Care Act, the President told the American Medical Association that he did not favor capping noneconomic damages because it can be unfair to patients.

The AMA has been pushing to get medical liability reform back at the top of the congressional agenda after it was left out of the ACA.

Dr. Ardis Dee Hoven, AMA chairwoman, recently testified before the House Judiciary Committee about the pressure physicians face from malpractice suits.

An AMA survey found that 61% of physicians age 55 and older had been sued at least once in their careers, with an average of 1.6 claims per doctor. But certain specialties, like obstetrics-gynecology and surgery, had much higher rates.

Many of the lawsuits are without merit, Dr. Hoven testified to the committee. The AMA survey found that 65% of claims were dropped, dismissed, or withdrawn. But it still cost about $20,000 per claim to defend the suits that were ultimately dropped, according to the report.

The American College of Physicians, which also supports the HEALTH Act, is calling on Congress to consider other reforms to reduce defensive medicine, such as health courts. The ACP is asking Congress to pass legislation that would allow for pilot testing of health courts on a national scale.

Health courts are a no-fault system in which cases are heard by specially trained judges with access to independent medical experts. Health court judges would be able to authorize awards based on the damages incurred.

The issue of medical liability reform is back in the headlines since President Obama said he would consider some type of reform to curb frivolous lawsuits. But physicians say there are plenty of political obstacles to making meaningful changes to the tort system.

One of the major hurdles, according to Texas Medical Association president Susan Rudd Bailey, will be getting a bill passed by the Democratic-controlled Senate. Democrats have historically opposed capping noneconomic damages, otherwise known as pain and suffering awards, which have been at the heart of the tort reforms passed in Texas and California.

"This is no slam dunk," said Dr. Bailey, an allergist in Fort Worth.

The Texas Medical Association is one of more than 100 state and national medical organizations that have endorsed new federal legislation aimed at reducing medical liability lawsuits. The Help Efficient, Accessible, Low-Cost, Timely Healthcare (HEALTH) Act, H.R. 5, is modeled after California’s Medical Injury Compensation Reform Act (MICRA), which has been in place for about 30 years. The new federal legislation would place a $250,000 cap on noneconomic damages and would require that medical liability suits must be filed within 3 years of the injury in most cases.

The cap on noneconomic damages is the cornerstone of the Texas medical liability reform law enacted in 2003. The cap, Dr. Bailey said, has helped to reduce premiums and improve access for patients. For example, 90% of the state’s physicians have seen their malpractice insurance rates cut by 30% or more, according to the Texas Medical Association.

In 2001– before the legislation was enacted – the number of newly licensed physicians in Texas was at a decade-long low of 2,088. By 2008, that number had risen to 3,621. And since enactment, the number of physicians practicing in previously scare specialties including obstetrics, orthopedic surgy, neurosurgery, emergency medicine, and cardiovascular surgery has increased, according to figures from the Texas Medical Association.

Dr. Alex Valadka, a neurosurgeon at the Seton Brain and Spine Institute in Austin, said the 2003 tort law has dramatically improved the practice climate in the state. Anecdotally, Dr. Valadka says he’s getting fewer calls from other physicians seeking consultations on complicated cases because there are more neurosurgeons to take on the work. Dr. Valadka said he hopes that similar reforms can be passed at the federal level, but he said he’s doubtful that President Obama’s vision for tort reform will look like the Texas statute.

So far, the President has been light on specifics. In 2009, as Congress was considering the Affordable Care Act, the President told the American Medical Association that he did not favor capping noneconomic damages because it can be unfair to patients.

The AMA has been pushing to get medical liability reform back at the top of the congressional agenda after it was left out of the ACA.

Dr. Ardis Dee Hoven, AMA chairwoman, recently testified before the House Judiciary Committee about the pressure physicians face from malpractice suits.

An AMA survey found that 61% of physicians age 55 and older had been sued at least once in their careers, with an average of 1.6 claims per doctor. But certain specialties, like obstetrics-gynecology and surgery, had much higher rates.

Many of the lawsuits are without merit, Dr. Hoven testified to the committee. The AMA survey found that 65% of claims were dropped, dismissed, or withdrawn. But it still cost about $20,000 per claim to defend the suits that were ultimately dropped, according to the report.

The American College of Physicians, which also supports the HEALTH Act, is calling on Congress to consider other reforms to reduce defensive medicine, such as health courts. The ACP is asking Congress to pass legislation that would allow for pilot testing of health courts on a national scale.

Health courts are a no-fault system in which cases are heard by specially trained judges with access to independent medical experts. Health court judges would be able to authorize awards based on the damages incurred.

The issue of medical liability reform is back in the headlines since President Obama said he would consider some type of reform to curb frivolous lawsuits. But physicians say there are plenty of political obstacles to making meaningful changes to the tort system.

One of the major hurdles, according to Texas Medical Association president Susan Rudd Bailey, will be getting a bill passed by the Democratic-controlled Senate. Democrats have historically opposed capping noneconomic damages, otherwise known as pain and suffering awards, which have been at the heart of the tort reforms passed in Texas and California.

"This is no slam dunk," said Dr. Bailey, an allergist in Fort Worth.

The Texas Medical Association is one of more than 100 state and national medical organizations that have endorsed new federal legislation aimed at reducing medical liability lawsuits. The Help Efficient, Accessible, Low-Cost, Timely Healthcare (HEALTH) Act, H.R. 5, is modeled after California’s Medical Injury Compensation Reform Act (MICRA), which has been in place for about 30 years. The new federal legislation would place a $250,000 cap on noneconomic damages and would require that medical liability suits must be filed within 3 years of the injury in most cases.

The cap on noneconomic damages is the cornerstone of the Texas medical liability reform law enacted in 2003. The cap, Dr. Bailey said, has helped to reduce premiums and improve access for patients. For example, 90% of the state’s physicians have seen their malpractice insurance rates cut by 30% or more, according to the Texas Medical Association.

In 2001– before the legislation was enacted – the number of newly licensed physicians in Texas was at a decade-long low of 2,088. By 2008, that number had risen to 3,621. And since enactment, the number of physicians practicing in previously scare specialties including obstetrics, orthopedic surgy, neurosurgery, emergency medicine, and cardiovascular surgery has increased, according to figures from the Texas Medical Association.

Dr. Alex Valadka, a neurosurgeon at the Seton Brain and Spine Institute in Austin, said the 2003 tort law has dramatically improved the practice climate in the state. Anecdotally, Dr. Valadka says he’s getting fewer calls from other physicians seeking consultations on complicated cases because there are more neurosurgeons to take on the work. Dr. Valadka said he hopes that similar reforms can be passed at the federal level, but he said he’s doubtful that President Obama’s vision for tort reform will look like the Texas statute.

So far, the President has been light on specifics. In 2009, as Congress was considering the Affordable Care Act, the President told the American Medical Association that he did not favor capping noneconomic damages because it can be unfair to patients.

The AMA has been pushing to get medical liability reform back at the top of the congressional agenda after it was left out of the ACA.

Dr. Ardis Dee Hoven, AMA chairwoman, recently testified before the House Judiciary Committee about the pressure physicians face from malpractice suits.

An AMA survey found that 61% of physicians age 55 and older had been sued at least once in their careers, with an average of 1.6 claims per doctor. But certain specialties, like obstetrics-gynecology and surgery, had much higher rates.

Many of the lawsuits are without merit, Dr. Hoven testified to the committee. The AMA survey found that 65% of claims were dropped, dismissed, or withdrawn. But it still cost about $20,000 per claim to defend the suits that were ultimately dropped, according to the report.

The American College of Physicians, which also supports the HEALTH Act, is calling on Congress to consider other reforms to reduce defensive medicine, such as health courts. The ACP is asking Congress to pass legislation that would allow for pilot testing of health courts on a national scale.

Health courts are a no-fault system in which cases are heard by specially trained judges with access to independent medical experts. Health court judges would be able to authorize awards based on the damages incurred.

President Obama sent a clear message to Republican lawmakers who seek to repeal the Affordable Care Act -- the health reform law is here to stay.

In his second State of the Union address on Jan. 25, the president said that he is willing to work with lawmakers to improve the law by "making care better or more affordable," but he won't reverse fundamental parts of the law such as the ban on discriminating against individuals with pre-existing medical conditions.

"Let's fix what needs fixing and move forward," President Obama said during his speech.

But Republicans in Congress seem unlikely to let up on their attack. In the Republican response to the speech, Rep. Paul Ryan of Wisconsin said the GOP will seek to replace the Affordable Care Act with legislation that would reduce cost and expand coverage.

Rep. Ryan, chairman of the House Budget Committee, said that the ACA will cause millions of insured people to lose their current coverage and is "accelerating our country toward bankruptcy."

Despite the wrangling over health reform, the president may have found common ground with Republicans on the issue of medical liability reform.

As part of an effort to bring down health spending, President Obama said he is willing to work with lawmakers to reform the tort system by reining in frivolous lawsuits.

Republican lawmakers have already proposed legislation that would place a $250,000 cap on noneconomic damages. The Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act of 2011 (H.R. 5) would also mandate that medical liability suits must be filed within 3 years of the injury in most cases. The legislation has the support of the American Medical Association and 100 medical organizations.

President Obama sent a clear message to Republican lawmakers who seek to repeal the Affordable Care Act -- the health reform law is here to stay.

In his second State of the Union address on Jan. 25, the president said that he is willing to work with lawmakers to improve the law by "making care better or more affordable," but he won't reverse fundamental parts of the law such as the ban on discriminating against individuals with pre-existing medical conditions.

"Let's fix what needs fixing and move forward," President Obama said during his speech.

But Republicans in Congress seem unlikely to let up on their attack. In the Republican response to the speech, Rep. Paul Ryan of Wisconsin said the GOP will seek to replace the Affordable Care Act with legislation that would reduce cost and expand coverage.

Rep. Ryan, chairman of the House Budget Committee, said that the ACA will cause millions of insured people to lose their current coverage and is "accelerating our country toward bankruptcy."

Despite the wrangling over health reform, the president may have found common ground with Republicans on the issue of medical liability reform.

As part of an effort to bring down health spending, President Obama said he is willing to work with lawmakers to reform the tort system by reining in frivolous lawsuits.

Republican lawmakers have already proposed legislation that would place a $250,000 cap on noneconomic damages. The Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act of 2011 (H.R. 5) would also mandate that medical liability suits must be filed within 3 years of the injury in most cases. The legislation has the support of the American Medical Association and 100 medical organizations.

President Obama sent a clear message to Republican lawmakers who seek to repeal the Affordable Care Act -- the health reform law is here to stay.

In his second State of the Union address on Jan. 25, the president said that he is willing to work with lawmakers to improve the law by "making care better or more affordable," but he won't reverse fundamental parts of the law such as the ban on discriminating against individuals with pre-existing medical conditions.

"Let's fix what needs fixing and move forward," President Obama said during his speech.

But Republicans in Congress seem unlikely to let up on their attack. In the Republican response to the speech, Rep. Paul Ryan of Wisconsin said the GOP will seek to replace the Affordable Care Act with legislation that would reduce cost and expand coverage.

Rep. Ryan, chairman of the House Budget Committee, said that the ACA will cause millions of insured people to lose their current coverage and is "accelerating our country toward bankruptcy."

Despite the wrangling over health reform, the president may have found common ground with Republicans on the issue of medical liability reform.

As part of an effort to bring down health spending, President Obama said he is willing to work with lawmakers to reform the tort system by reining in frivolous lawsuits.

Republican lawmakers have already proposed legislation that would place a $250,000 cap on noneconomic damages. The Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act of 2011 (H.R. 5) would also mandate that medical liability suits must be filed within 3 years of the injury in most cases. The legislation has the support of the American Medical Association and 100 medical organizations.

President Obama sent a clear message to Republican lawmakers who seek to repeal the Affordable Care Act -- the health reform law is here to stay.

In his second State of the Union address on Jan. 25, the president said that he is willing to work with lawmakers to improve the law by "making care better or more affordable," but he won’t reverse fundamental parts of the law such as the ban on discriminating against individuals with pre-existing medical conditions.

"Let’s fix what needs fixing and move forward," President Obama said during his speech.

But Republicans in Congress seem unlikely to let up on their attack. In the Republican response to the speech, Rep. Paul Ryan of Wisconsin said the GOP will seek to replace the Affordable Care Act with legislation that would reduce cost and expand coverage.

Rep. Ryan, chairman of the House Budget Committee, said that the ACA will cause millions of insured people to lose their current coverage and is "accelerating our country toward bankruptcy."

Despite the wrangling over health reform, the president may have found common ground with Republicans on the issue of medical liability reform.

As part of an effort to bring down health spending, President Obama said he is willing to work with lawmakers to reform the tort system by reining in frivolous lawsuits.

Republican lawmakers have already proposed legislation that would place a $250,000 cap on noneconomic damages. The Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act of 2011 (H.R. 5) would also mandate that medical liability suits must be filed within 3 years of the injury in most cases. The legislation has the support of the American Medical Association and 100 medical organizations.

President Obama sent a clear message to Republican lawmakers who seek to repeal the Affordable Care Act -- the health reform law is here to stay.

In his second State of the Union address on Jan. 25, the president said that he is willing to work with lawmakers to improve the law by "making care better or more affordable," but he won’t reverse fundamental parts of the law such as the ban on discriminating against individuals with pre-existing medical conditions.

"Let’s fix what needs fixing and move forward," President Obama said during his speech.

But Republicans in Congress seem unlikely to let up on their attack. In the Republican response to the speech, Rep. Paul Ryan of Wisconsin said the GOP will seek to replace the Affordable Care Act with legislation that would reduce cost and expand coverage.

Rep. Ryan, chairman of the House Budget Committee, said that the ACA will cause millions of insured people to lose their current coverage and is "accelerating our country toward bankruptcy."

Despite the wrangling over health reform, the president may have found common ground with Republicans on the issue of medical liability reform.

As part of an effort to bring down health spending, President Obama said he is willing to work with lawmakers to reform the tort system by reining in frivolous lawsuits.

Republican lawmakers have already proposed legislation that would place a $250,000 cap on noneconomic damages. The Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act of 2011 (H.R. 5) would also mandate that medical liability suits must be filed within 3 years of the injury in most cases. The legislation has the support of the American Medical Association and 100 medical organizations.

President Obama sent a clear message to Republican lawmakers who seek to repeal the Affordable Care Act -- the health reform law is here to stay.

In his second State of the Union address on Jan. 25, the president said that he is willing to work with lawmakers to improve the law by "making care better or more affordable," but he won’t reverse fundamental parts of the law such as the ban on discriminating against individuals with pre-existing medical conditions.

"Let’s fix what needs fixing and move forward," President Obama said during his speech.

But Republicans in Congress seem unlikely to let up on their attack. In the Republican response to the speech, Rep. Paul Ryan of Wisconsin said the GOP will seek to replace the Affordable Care Act with legislation that would reduce cost and expand coverage.

Rep. Ryan, chairman of the House Budget Committee, said that the ACA will cause millions of insured people to lose their current coverage and is "accelerating our country toward bankruptcy."

Despite the wrangling over health reform, the president may have found common ground with Republicans on the issue of medical liability reform.

As part of an effort to bring down health spending, President Obama said he is willing to work with lawmakers to reform the tort system by reining in frivolous lawsuits.

Republican lawmakers have already proposed legislation that would place a $250,000 cap on noneconomic damages. The Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act of 2011 (H.R. 5) would also mandate that medical liability suits must be filed within 3 years of the injury in most cases. The legislation has the support of the American Medical Association and 100 medical organizations.

President Obama sent a clear message to Republican lawmakers who seek to repeal the Affordable Care Act -- the health reform law is here to stay.

In his second State of the Union address on Jan. 25, the president said that he is willing to work with lawmakers to improve the law by "making care better or more affordable," but he won’t reverse fundamental parts of the law such as the ban on discriminating against individuals with pre-existing medical conditions.

"Let’s fix what needs fixing and move forward," President Obama said during his speech.

But Republicans in Congress seem unlikely to let up on their attack. In the Republican response to the speech, Rep. Paul Ryan of Wisconsin said the GOP will seek to replace the Affordable Care Act with legislation that would reduce cost and expand coverage.

Rep. Ryan, chairman of the House Budget Committee, said that the ACA will cause millions of insured people to lose their current coverage and is "accelerating our country toward bankruptcy."

Despite the wrangling over health reform, the president may have found common ground with Republicans on the issue of medical liability reform.

As part of an effort to bring down health spending, President Obama said he is willing to work with lawmakers to reform the tort system by reining in frivolous lawsuits.

Republican lawmakers have already proposed legislation that would place a $250,000 cap on noneconomic damages. The Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act of 2011 (H.R. 5) would also mandate that medical liability suits must be filed within 3 years of the injury in most cases. The legislation has the support of the American Medical Association and 100 medical organizations.

President Obama sent a clear message to Republican lawmakers who seek to repeal the Affordable Care Act -- the health reform law is here to stay.

In his second State of the Union address on Jan. 25, the president said that he is willing to work with lawmakers to improve the law by "making care better or more affordable," but he won’t reverse fundamental parts of the law such as the ban on discriminating against individuals with pre-existing medical conditions.

"Let’s fix what needs fixing and move forward," President Obama said during his speech.

But Republicans in Congress seem unlikely to let up on their attack. In the Republican response to the speech, Rep. Paul Ryan of Wisconsin said the GOP will seek to replace the Affordable Care Act with legislation that would reduce cost and expand coverage.

Rep. Ryan, chairman of the House Budget Committee, said that the ACA will cause millions of insured people to lose their current coverage and is "accelerating our country toward bankruptcy."

Despite the wrangling over health reform, the president may have found common ground with Republicans on the issue of medical liability reform.

As part of an effort to bring down health spending, President Obama said he is willing to work with lawmakers to reform the tort system by reining in frivolous lawsuits.

Republican lawmakers have already proposed legislation that would place a $250,000 cap on noneconomic damages. The Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act of 2011 (H.R. 5) would also mandate that medical liability suits must be filed within 3 years of the injury in most cases. The legislation has the support of the American Medical Association and 100 medical organizations.

President Obama sent a clear message to Republican lawmakers who seek to repeal the Affordable Care Act -- the health reform law is here to stay.

In his second State of the Union address on Jan. 25, the president said that he is willing to work with lawmakers to improve the law by "making care better or more affordable," but he won’t reverse fundamental parts of the law such as the ban on discriminating against individuals with pre-existing medical conditions.

"Let’s fix what needs fixing and move forward," President Obama said during his speech.

But Republicans in Congress seem unlikely to let up on their attack. In the Republican response to the speech, Rep. Paul Ryan of Wisconsin said the GOP will seek to replace the Affordable Care Act with legislation that would reduce cost and expand coverage.

Rep. Ryan, chairman of the House Budget Committee, said that the ACA will cause millions of insured people to lose their current coverage and is "accelerating our country toward bankruptcy."

Despite the wrangling over health reform, the president may have found common ground with Republicans on the issue of medical liability reform.

As part of an effort to bring down health spending, President Obama said he is willing to work with lawmakers to reform the tort system by reining in frivolous lawsuits.

Republican lawmakers have already proposed legislation that would place a $250,000 cap on noneconomic damages. The Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act of 2011 (H.R. 5) would also mandate that medical liability suits must be filed within 3 years of the injury in most cases. The legislation has the support of the American Medical Association and 100 medical organizations.

A new federal initiative offering bonus payments to physicians who successfully implement electronic health records launched Jan. 3, and early signs indicate it could help spur adoption of the technology.

Officials in the Office of the National Coordinator for Health Information Technology recently released two surveys showing that more than 40% of office-based physicians and 80% of hospitals plan to seek federal incentives for the adoption and use of EHRs under Medicare and Medicaid.

The incentive programs, which launched at the start of the year, offer payments to physicians for using health information technology (HIT) to improve patient care. The federal government recently issued regulations detailing how physicians and hospitals can meet standards for so-called "meaningful use" of the technology. Physicians who meet the criteria are eligible to receive up to $44,000 over 5 years under the Medicare program or $63,750 in 6 years under the Medicaid program. Eligible hospitals could receive millions of dollars, according to the Centers for Medicare and Medicaid Services (CMS).

The survey of office-based physicians, conducted by the Centers for Disease Control and Prevention, found that 41% plan to achieve meaningful use and seek federal incentive payments. Of those, about 80% said that they plan to enroll during first stage of the program, this year or next.

A separate survey, conducted by the American Hospital Association, found that 81% of hospitals plan to achieve meaningful use and apply for incentive payments, with about 65% enrolling in the same time frame.

While the federal government has promoting these incentives for more than a year, it was uncertain whether physicians would choose to participate.

Officials at the American Academy of Family Physicians said that while they do not have concrete data, but informal polls of their members show high interest in the incentives. Dr. Steven Waldren, director of the Center for Health IT at the AAFP, said that among physicians who attended lectures on meaningful use at the group’s annual meeting last fall, about 80% reported that they currently use an EHR in their practice and about 90% said they plan to try to achieve meaningful use this year.

It’s a biased sample, Dr. Waldren said, but it still paints a picture. "What it kind of tells us is that there are a lot of doctors out there, especially those that have adopted the technology, [who] are trying to figure out how to be meaningful users in 2011."

The big question is how many physicians will be able to convert their interest in the program into the ability to achieve meaningful use of EHRs, he added.

Dr. Waldren said most physicians will be able to meet the current thresholds for functions like electronic prescribing, which are outlined in the meaningful use criteria. However, the greater challenge will come in capturing and reporting that data to the government, he said.

Dr. Waldren recommended that physicians seek out the Regional Extension Centers set up by the federal government. These centers have been established around the country and are specifically charged with aiding small practices, primary care physicians, and those working in underserved areas. But he also cautioned that the level of expertise may vary by center.

While many of the barriers to EHR adoption remain the same, the financial incentives seem to be helping physicians who were "on the fence," move in the direction of purchasing a system, said Dr. Michael S. Barr, a senior vice president at the American College of Physicians.

The success of the program can’t be judged, he said, at least until figures are available on how many physicians met the stage 1 meaningful use standards, said Dr. Barr, who also serves on the Health IT Policy Committee’s meaningful use workgroup. As the incentive program progresses and the quality measures become more robust, the data that is reported should also show whether the program has resulted in improvements in clinical quality of care, Dr. Barr said.

A new federal initiative offering bonus payments to physicians who successfully implement electronic health records launched Jan. 3, and early signs indicate it could help spur adoption of the technology.

Officials in the Office of the National Coordinator for Health Information Technology recently released two surveys showing that more than 40% of office-based physicians and 80% of hospitals plan to seek federal incentives for the adoption and use of EHRs under Medicare and Medicaid.

The incentive programs, which launched at the start of the year, offer payments to physicians for using health information technology (HIT) to improve patient care. The federal government recently issued regulations detailing how physicians and hospitals can meet standards for so-called "meaningful use" of the technology. Physicians who meet the criteria are eligible to receive up to $44,000 over 5 years under the Medicare program or $63,750 in 6 years under the Medicaid program. Eligible hospitals could receive millions of dollars, according to the Centers for Medicare and Medicaid Services (CMS).

The survey of office-based physicians, conducted by the Centers for Disease Control and Prevention, found that 41% plan to achieve meaningful use and seek federal incentive payments. Of those, about 80% said that they plan to enroll during first stage of the program, this year or next.

A separate survey, conducted by the American Hospital Association, found that 81% of hospitals plan to achieve meaningful use and apply for incentive payments, with about 65% enrolling in the same time frame.

While the federal government has promoting these incentives for more than a year, it was uncertain whether physicians would choose to participate.

Officials at the American Academy of Family Physicians said that while they do not have concrete data, but informal polls of their members show high interest in the incentives. Dr. Steven Waldren, director of the Center for Health IT at the AAFP, said that among physicians who attended lectures on meaningful use at the group’s annual meeting last fall, about 80% reported that they currently use an EHR in their practice and about 90% said they plan to try to achieve meaningful use this year.

It’s a biased sample, Dr. Waldren said, but it still paints a picture. "What it kind of tells us is that there are a lot of doctors out there, especially those that have adopted the technology, [who] are trying to figure out how to be meaningful users in 2011."

The big question is how many physicians will be able to convert their interest in the program into the ability to achieve meaningful use of EHRs, he added.

Dr. Waldren said most physicians will be able to meet the current thresholds for functions like electronic prescribing, which are outlined in the meaningful use criteria. However, the greater challenge will come in capturing and reporting that data to the government, he said.

Dr. Waldren recommended that physicians seek out the Regional Extension Centers set up by the federal government. These centers have been established around the country and are specifically charged with aiding small practices, primary care physicians, and those working in underserved areas. But he also cautioned that the level of expertise may vary by center.

While many of the barriers to EHR adoption remain the same, the financial incentives seem to be helping physicians who were "on the fence," move in the direction of purchasing a system, said Dr. Michael S. Barr, a senior vice president at the American College of Physicians.

The success of the program can’t be judged, he said, at least until figures are available on how many physicians met the stage 1 meaningful use standards, said Dr. Barr, who also serves on the Health IT Policy Committee’s meaningful use workgroup. As the incentive program progresses and the quality measures become more robust, the data that is reported should also show whether the program has resulted in improvements in clinical quality of care, Dr. Barr said.

A new federal initiative offering bonus payments to physicians who successfully implement electronic health records launched Jan. 3, and early signs indicate it could help spur adoption of the technology.

Officials in the Office of the National Coordinator for Health Information Technology recently released two surveys showing that more than 40% of office-based physicians and 80% of hospitals plan to seek federal incentives for the adoption and use of EHRs under Medicare and Medicaid.

The incentive programs, which launched at the start of the year, offer payments to physicians for using health information technology (HIT) to improve patient care. The federal government recently issued regulations detailing how physicians and hospitals can meet standards for so-called "meaningful use" of the technology. Physicians who meet the criteria are eligible to receive up to $44,000 over 5 years under the Medicare program or $63,750 in 6 years under the Medicaid program. Eligible hospitals could receive millions of dollars, according to the Centers for Medicare and Medicaid Services (CMS).

The survey of office-based physicians, conducted by the Centers for Disease Control and Prevention, found that 41% plan to achieve meaningful use and seek federal incentive payments. Of those, about 80% said that they plan to enroll during first stage of the program, this year or next.

A separate survey, conducted by the American Hospital Association, found that 81% of hospitals plan to achieve meaningful use and apply for incentive payments, with about 65% enrolling in the same time frame.

While the federal government has promoting these incentives for more than a year, it was uncertain whether physicians would choose to participate.

Officials at the American Academy of Family Physicians said that while they do not have concrete data, but informal polls of their members show high interest in the incentives. Dr. Steven Waldren, director of the Center for Health IT at the AAFP, said that among physicians who attended lectures on meaningful use at the group’s annual meeting last fall, about 80% reported that they currently use an EHR in their practice and about 90% said they plan to try to achieve meaningful use this year.

It’s a biased sample, Dr. Waldren said, but it still paints a picture. "What it kind of tells us is that there are a lot of doctors out there, especially those that have adopted the technology, [who] are trying to figure out how to be meaningful users in 2011."

The big question is how many physicians will be able to convert their interest in the program into the ability to achieve meaningful use of EHRs, he added.

Dr. Waldren said most physicians will be able to meet the current thresholds for functions like electronic prescribing, which are outlined in the meaningful use criteria. However, the greater challenge will come in capturing and reporting that data to the government, he said.

Dr. Waldren recommended that physicians seek out the Regional Extension Centers set up by the federal government. These centers have been established around the country and are specifically charged with aiding small practices, primary care physicians, and those working in underserved areas. But he also cautioned that the level of expertise may vary by center.

While many of the barriers to EHR adoption remain the same, the financial incentives seem to be helping physicians who were "on the fence," move in the direction of purchasing a system, said Dr. Michael S. Barr, a senior vice president at the American College of Physicians.

The success of the program can’t be judged, he said, at least until figures are available on how many physicians met the stage 1 meaningful use standards, said Dr. Barr, who also serves on the Health IT Policy Committee’s meaningful use workgroup. As the incentive program progresses and the quality measures become more robust, the data that is reported should also show whether the program has resulted in improvements in clinical quality of care, Dr. Barr said.

A new federal initiative offering bonus payments to physicians who successfully implement electronic health records launched Jan. 3, and early signs indicate it could help spur adoption of the technology.

Officials in the Office of the National Coordinator for Health Information Technology recently released two surveys showing that more than 40% of office-based physicians and 80% of hospitals plan to seek federal incentives for the adoption and use of EHRs under Medicare and Medicaid.

The incentive programs, which launched at the start of the year, offer payments to physicians for using health information technology (HIT) to improve patient care. The federal government recently issued regulations detailing how physicians and hospitals can meet standards for so-called meaningful use of the technology.

Physicians who meet the criteria are eligible to receive up to $44,000 over 5 years under the Medicare program or $63,750 in 6 years under the Medicaid program. Eligible hospitals could receive millions of dollars, according to the Centers for Medicare and Medicaid Services (CMS).

The survey of office-based physicians, conducted by the Centers for Disease Control and Prevention, found that 41% plan to achieve meaningful use and seek federal incentive payments. Of those, about 80% said that they plan to enroll during first stage of the program, this year or next.

A separate survey, conducted by the American Hospital Association, found that 81% of hospitals plan to achieve meaningful use and apply for incentive payments, with about 65% enrolling in the same time frame.

While many of the barriers to EHR adoption remain the same, the financial incentives seem to be helping physicians who were "on the fence," move in the direction of purchasing a system, said Dr. Michael S. Barr, a senior vice president at the American College of Physicians.

The success of the program can't be judged, he said, at least until figures are available on how many physicians met the stage 1 meaningful use standards, said Dr. Barr, who also serves on the Health IT Policy Committee's meaningful use workgroup. As the incentive program progresses and the quality measures become more robust, the data that is reported should also show whether the program has resulted in improvements in clinical quality of care, Dr. Barr said.

A new federal initiative offering bonus payments to physicians who successfully implement electronic health records launched Jan. 3, and early signs indicate it could help spur adoption of the technology.

Officials in the Office of the National Coordinator for Health Information Technology recently released two surveys showing that more than 40% of office-based physicians and 80% of hospitals plan to seek federal incentives for the adoption and use of EHRs under Medicare and Medicaid.

The incentive programs, which launched at the start of the year, offer payments to physicians for using health information technology (HIT) to improve patient care. The federal government recently issued regulations detailing how physicians and hospitals can meet standards for so-called meaningful use of the technology.

Physicians who meet the criteria are eligible to receive up to $44,000 over 5 years under the Medicare program or $63,750 in 6 years under the Medicaid program. Eligible hospitals could receive millions of dollars, according to the Centers for Medicare and Medicaid Services (CMS).

The survey of office-based physicians, conducted by the Centers for Disease Control and Prevention, found that 41% plan to achieve meaningful use and seek federal incentive payments. Of those, about 80% said that they plan to enroll during first stage of the program, this year or next.

A separate survey, conducted by the American Hospital Association, found that 81% of hospitals plan to achieve meaningful use and apply for incentive payments, with about 65% enrolling in the same time frame.

While many of the barriers to EHR adoption remain the same, the financial incentives seem to be helping physicians who were "on the fence," move in the direction of purchasing a system, said Dr. Michael S. Barr, a senior vice president at the American College of Physicians.

The success of the program can't be judged, he said, at least until figures are available on how many physicians met the stage 1 meaningful use standards, said Dr. Barr, who also serves on the Health IT Policy Committee's meaningful use workgroup. As the incentive program progresses and the quality measures become more robust, the data that is reported should also show whether the program has resulted in improvements in clinical quality of care, Dr. Barr said.

A new federal initiative offering bonus payments to physicians who successfully implement electronic health records launched Jan. 3, and early signs indicate it could help spur adoption of the technology.

Officials in the Office of the National Coordinator for Health Information Technology recently released two surveys showing that more than 40% of office-based physicians and 80% of hospitals plan to seek federal incentives for the adoption and use of EHRs under Medicare and Medicaid.

The incentive programs, which launched at the start of the year, offer payments to physicians for using health information technology (HIT) to improve patient care. The federal government recently issued regulations detailing how physicians and hospitals can meet standards for so-called meaningful use of the technology.

Physicians who meet the criteria are eligible to receive up to $44,000 over 5 years under the Medicare program or $63,750 in 6 years under the Medicaid program. Eligible hospitals could receive millions of dollars, according to the Centers for Medicare and Medicaid Services (CMS).

The survey of office-based physicians, conducted by the Centers for Disease Control and Prevention, found that 41% plan to achieve meaningful use and seek federal incentive payments. Of those, about 80% said that they plan to enroll during first stage of the program, this year or next.

A separate survey, conducted by the American Hospital Association, found that 81% of hospitals plan to achieve meaningful use and apply for incentive payments, with about 65% enrolling in the same time frame.

While many of the barriers to EHR adoption remain the same, the financial incentives seem to be helping physicians who were "on the fence," move in the direction of purchasing a system, said Dr. Michael S. Barr, a senior vice president at the American College of Physicians.

The success of the program can't be judged, he said, at least until figures are available on how many physicians met the stage 1 meaningful use standards, said Dr. Barr, who also serves on the Health IT Policy Committee's meaningful use workgroup. As the incentive program progresses and the quality measures become more robust, the data that is reported should also show whether the program has resulted in improvements in clinical quality of care, Dr. Barr said.

A new federal initiative offering bonus payments to physicians who successfully implement electronic health records launched Jan. 3, and early signs indicate it could help spur adoption of the technology.

Officials in the Office of the National Coordinator for Health Information Technology recently released two surveys showing that more than 40% of office-based physicians and 80% of hospitals plan to seek federal incentives for the adoption and use of EHRs under Medicare and Medicaid.

The incentive programs, which launched at the start of the year, offer payments to physicians for using health information technology (HIT) to improve patient care. The federal government recently issued regulations detailing how physicians and hospitals can meet standards for so-called "meaningful use" of the technology. Physicians who meet the criteria are eligible to receive up to $44,000 over 5 years under the Medicare program or $63,750 in 6 years under the Medicaid program. Eligible hospitals could receive millions of dollars, according to the Centers for Medicare and Medicaid Services (CMS).

The survey of office-based physicians, conducted by the Centers for Disease Control and Prevention, found that 41% plan to achieve meaningful use and seek federal incentive payments. Of those, about 80% said that they plan to enroll during first stage of the program, this year or next.

A separate survey, conducted by the American Hospital Association, found that 81% of hospitals plan to achieve meaningful use and apply for incentive payments, with about 65% enrolling in the same time frame.

While the federal government has promoting these incentives for more than a year, it was uncertain whether physicians would choose to participate.

Officials at the American Academy of Family Physicians said that while they do not have concrete data, but informal polls of their members show high interest in the incentives. Dr. Steven Waldren, director of the Center for Health IT at the AAFP, said that among physicians who attended lectures on meaningful use at the group’s annual meeting last fall, about 80% reported that they currently use an EHR in their practice and about 90% said they plan to try to achieve meaningful use this year.

It’s a biased sample, Dr. Waldren said, but it still paints a picture. "What it kind of tells us is that there are a lot of doctors out there, especially those that have adopted the technology, [who] are trying to figure out how to be meaningful users in 2011."

The big question is how many physicians will be able to convert their interest in the program into the ability to achieve meaningful use of EHRs, he added.

Dr. Waldren said most physicians will be able to meet the current thresholds for functions like electronic prescribing, which are outlined in the meaningful use criteria. However, the greater challenge will come in capturing and reporting that data to the government, he said.

Dr. Waldren recommended that physicians seek out the Regional Extension Centers set up by the federal government. These centers have been established around the country and are specifically charged with aiding small practices, primary care physicians, and those working in underserved areas. But he also cautioned that the level of expertise may vary by center.

While many of the barriers to EHR adoption remain the same, the financial incentives seem to be helping physicians who were "on the fence," move in the direction of purchasing a system, said Dr. Michael S. Barr, a senior vice president at the American College of Physicians.

The success of the program can’t be judged, he said, at least until figures are available on how many physicians met the stage 1 meaningful use standards, said Dr. Barr, who also serves on the Health IT Policy Committee’s meaningful use workgroup. As the incentive program progresses and the quality measures become more robust, the data that is reported should also show whether the program has resulted in improvements in clinical quality of care, Dr. Barr said.

A new federal initiative offering bonus payments to physicians who successfully implement electronic health records launched Jan. 3, and early signs indicate it could help spur adoption of the technology.

Officials in the Office of the National Coordinator for Health Information Technology recently released two surveys showing that more than 40% of office-based physicians and 80% of hospitals plan to seek federal incentives for the adoption and use of EHRs under Medicare and Medicaid.

The incentive programs, which launched at the start of the year, offer payments to physicians for using health information technology (HIT) to improve patient care. The federal government recently issued regulations detailing how physicians and hospitals can meet standards for so-called "meaningful use" of the technology. Physicians who meet the criteria are eligible to receive up to $44,000 over 5 years under the Medicare program or $63,750 in 6 years under the Medicaid program. Eligible hospitals could receive millions of dollars, according to the Centers for Medicare and Medicaid Services (CMS).

The survey of office-based physicians, conducted by the Centers for Disease Control and Prevention, found that 41% plan to achieve meaningful use and seek federal incentive payments. Of those, about 80% said that they plan to enroll during first stage of the program, this year or next.

A separate survey, conducted by the American Hospital Association, found that 81% of hospitals plan to achieve meaningful use and apply for incentive payments, with about 65% enrolling in the same time frame.

While the federal government has promoting these incentives for more than a year, it was uncertain whether physicians would choose to participate.

Officials at the American Academy of Family Physicians said that while they do not have concrete data, but informal polls of their members show high interest in the incentives. Dr. Steven Waldren, director of the Center for Health IT at the AAFP, said that among physicians who attended lectures on meaningful use at the group’s annual meeting last fall, about 80% reported that they currently use an EHR in their practice and about 90% said they plan to try to achieve meaningful use this year.

It’s a biased sample, Dr. Waldren said, but it still paints a picture. "What it kind of tells us is that there are a lot of doctors out there, especially those that have adopted the technology, [who] are trying to figure out how to be meaningful users in 2011."

The big question is how many physicians will be able to convert their interest in the program into the ability to achieve meaningful use of EHRs, he added.

Dr. Waldren said most physicians will be able to meet the current thresholds for functions like electronic prescribing, which are outlined in the meaningful use criteria. However, the greater challenge will come in capturing and reporting that data to the government, he said.

Dr. Waldren recommended that physicians seek out the Regional Extension Centers set up by the federal government. These centers have been established around the country and are specifically charged with aiding small practices, primary care physicians, and those working in underserved areas. But he also cautioned that the level of expertise may vary by center.

While many of the barriers to EHR adoption remain the same, the financial incentives seem to be helping physicians who were "on the fence," move in the direction of purchasing a system, said Dr. Michael S. Barr, a senior vice president at the American College of Physicians.

The success of the program can’t be judged, he said, at least until figures are available on how many physicians met the stage 1 meaningful use standards, said Dr. Barr, who also serves on the Health IT Policy Committee’s meaningful use workgroup. As the incentive program progresses and the quality measures become more robust, the data that is reported should also show whether the program has resulted in improvements in clinical quality of care, Dr. Barr said.

A new federal initiative offering bonus payments to physicians who successfully implement electronic health records launched Jan. 3, and early signs indicate it could help spur adoption of the technology.

Officials in the Office of the National Coordinator for Health Information Technology recently released two surveys showing that more than 40% of office-based physicians and 80% of hospitals plan to seek federal incentives for the adoption and use of EHRs under Medicare and Medicaid.

The incentive programs, which launched at the start of the year, offer payments to physicians for using health information technology (HIT) to improve patient care. The federal government recently issued regulations detailing how physicians and hospitals can meet standards for so-called "meaningful use" of the technology. Physicians who meet the criteria are eligible to receive up to $44,000 over 5 years under the Medicare program or $63,750 in 6 years under the Medicaid program. Eligible hospitals could receive millions of dollars, according to the Centers for Medicare and Medicaid Services (CMS).

The survey of office-based physicians, conducted by the Centers for Disease Control and Prevention, found that 41% plan to achieve meaningful use and seek federal incentive payments. Of those, about 80% said that they plan to enroll during first stage of the program, this year or next.

A separate survey, conducted by the American Hospital Association, found that 81% of hospitals plan to achieve meaningful use and apply for incentive payments, with about 65% enrolling in the same time frame.

While the federal government has promoting these incentives for more than a year, it was uncertain whether physicians would choose to participate.

Officials at the American Academy of Family Physicians said that while they do not have concrete data, but informal polls of their members show high interest in the incentives. Dr. Steven Waldren, director of the Center for Health IT at the AAFP, said that among physicians who attended lectures on meaningful use at the group’s annual meeting last fall, about 80% reported that they currently use an EHR in their practice and about 90% said they plan to try to achieve meaningful use this year.

It’s a biased sample, Dr. Waldren said, but it still paints a picture. "What it kind of tells us is that there are a lot of doctors out there, especially those that have adopted the technology, [who] are trying to figure out how to be meaningful users in 2011."

The big question is how many physicians will be able to convert their interest in the program into the ability to achieve meaningful use of EHRs, he added.

Dr. Waldren said most physicians will be able to meet the current thresholds for functions like electronic prescribing, which are outlined in the meaningful use criteria. However, the greater challenge will come in capturing and reporting that data to the government, he said.

Dr. Waldren recommended that physicians seek out the Regional Extension Centers set up by the federal government. These centers have been established around the country and are specifically charged with aiding small practices, primary care physicians, and those working in underserved areas. But he also cautioned that the level of expertise may vary by center.

While many of the barriers to EHR adoption remain the same, the financial incentives seem to be helping physicians who were "on the fence," move in the direction of purchasing a system, said Dr. Michael S. Barr, a senior vice president at the American College of Physicians.

The success of the program can’t be judged, he said, at least until figures are available on how many physicians met the stage 1 meaningful use standards, said Dr. Barr, who also serves on the Health IT Policy Committee’s meaningful use workgroup. As the incentive program progresses and the quality measures become more robust, the data that is reported should also show whether the program has resulted in improvements in clinical quality of care, Dr. Barr said.

State medical boards are eyeing ways to overhaul the relicensure process so that it better measures a physician’s efforts to stay abreast of clinical developments.

Currently, while the public assumes that state licensure means that a physician remains competent, that’s just not the case, according to Richard A. Whitehouse, the executive director of the State Medical Board of Ohio.

"There is really no measure once someone is initially licensed and has met the threshold requirements for licensure," he said. "Absent CME requirements, there’s really nothing you can point to, to say that this person is maintaining their competency."

Officials involved in the redesign process, however, emphasize that the new requirements won’t be a burden on practicing physicians and that most doctors are already doing enough to meet the standards under development.

The Federation of State Medical Boards (FSMB), which represents the nation’s state medical boards, has been promoting the need to make relicensure a more robust process for several years.

Last spring, the organization’s House of Delegates approved a framework that lays out what the maintenance of licensure process would look like in general. And over the past few months, an implementation group made up of physicians and medical board officials has been filling in the details.

The expectation is that new maintenance of licensure requirements will involve three major components: a reflective self-assessment that calls for physicians to complete a certain number of accredited continuing medical education courses; an assessment of knowledge and skills, which could be a formal exam; and some measurement of performance in practice, in which physicians would compare their practice data to those for peers and to national benchmarks.

Dr. Humayun Chaudhry, president and CEO of the FSMB, said that one of the goals in redesigning the relicensure process is to minimize the burden on practicing physicians. To that end, the FSMB implementation group’s draft report calls on state medical boards to accept participation in maintenance of certification through the American Board of Medical Specialties, or osteopathic continuous certification through the American Osteopathic Association, as substantially meeting the requirements for maintenance of licensure. "That’s a big advance because a significant plurality of physicians are involved in those programs," Dr. Chaudhry said.

More than 300,000 physicians are engaged in maintenance of certification through the various boards of the American Board of Medical Specialties, and that number increases by about 50,000 physicians each year, according to Dr. Kevin B. Weiss, ABMS president and CEO.

Officials at the ABMS have been working closely with states for years on the issue of maintenance of licensure and plan to continue to be involved as states begin to pilot the concept over the next several months to ensure that board-certified physicians aren’t asked to do any "double work," Dr. Weiss said.

"We’re going to be very active in trying to help our physician community on a state-by-state basis," he said.

Officials at the FSMB are being careful to point out that maintenance of licensure and maintenance of certification are not meant to be equivalent. While maintenance of certification and osteopathic continuous certification could comply with the more robust relicensure requirements, board certification goes "above and beyond" basic licensure, Dr. Chaudhry said.

For the hundreds of thousands of physicians who aren’t engaged in some type of maintenance of certification process, the FSMB is working with states to develop alternative pathways to demonstrate ongoing clinical competence.

The timeline for the new requirements is fairly long, Dr. Chaudhry said. The FSMB is recommending that state medical boards implement the new approach in phases that in total could take up to 10 years. The first step for any state medical board that plans to go forward with maintenance of licensure is to spend the first year educating physicians, the public, and lawmakers about what is planned and why. And each of the three components of the process should take another 2-3 years to implement, he said.

"The vast majority of physicians are already doing things to stay up to date," Dr. Chaudhry said. "In that sense, [maintenance of licensure] is simply a means by which those physicians can demonstrate what it is that they are doing."

Dr. Whitehouse, who also serves on the FSMB’s implementation group on maintenance of licensure, agrees that the process will not be onerous for physicians who are making an effort to keep their clinical skills current.

Ohio is one of a handful of state medical boards that already has plans to move forward with maintenance of licensure. Mr. Whitehouse said that the medical boards have a responsibility to the public to make relicensure more meaningful. But making the process more robust is also beneficial to physicians because the medical board then becomes a reliable resource where patients can get objective assessments based on practice data, he said, rather than relying on anecdotal reports.

State medical boards are eyeing ways to overhaul the relicensure process so that it better measures a physician’s efforts to stay abreast of clinical developments.

Currently, while the public assumes that state licensure means that a physician remains competent, that’s just not the case, according to Richard A. Whitehouse, the executive director of the State Medical Board of Ohio.

"There is really no measure once someone is initially licensed and has met the threshold requirements for licensure," he said. "Absent CME requirements, there’s really nothing you can point to, to say that this person is maintaining their competency."

Officials involved in the redesign process, however, emphasize that the new requirements won’t be a burden on practicing physicians and that most doctors are already doing enough to meet the standards under development.

The Federation of State Medical Boards (FSMB), which represents the nation’s state medical boards, has been promoting the need to make relicensure a more robust process for several years.

Last spring, the organization’s House of Delegates approved a framework that lays out what the maintenance of licensure process would look like in general. And over the past few months, an implementation group made up of physicians and medical board officials has been filling in the details.

The expectation is that new maintenance of licensure requirements will involve three major components: a reflective self-assessment that calls for physicians to complete a certain number of accredited continuing medical education courses; an assessment of knowledge and skills, which could be a formal exam; and some measurement of performance in practice, in which physicians would compare their practice data to those for peers and to national benchmarks.

Dr. Humayun Chaudhry, president and CEO of the FSMB, said that one of the goals in redesigning the relicensure process is to minimize the burden on practicing physicians. To that end, the FSMB implementation group’s draft report calls on state medical boards to accept participation in maintenance of certification through the American Board of Medical Specialties, or osteopathic continuous certification through the American Osteopathic Association, as substantially meeting the requirements for maintenance of licensure. "That’s a big advance because a significant plurality of physicians are involved in those programs," Dr. Chaudhry said.

More than 300,000 physicians are engaged in maintenance of certification through the various boards of the American Board of Medical Specialties, and that number increases by about 50,000 physicians each year, according to Dr. Kevin B. Weiss, ABMS president and CEO.

Officials at the ABMS have been working closely with states for years on the issue of maintenance of licensure and plan to continue to be involved as states begin to pilot the concept over the next several months to ensure that board-certified physicians aren’t asked to do any "double work," Dr. Weiss said.

"We’re going to be very active in trying to help our physician community on a state-by-state basis," he said.

Officials at the FSMB are being careful to point out that maintenance of licensure and maintenance of certification are not meant to be equivalent. While maintenance of certification and osteopathic continuous certification could comply with the more robust relicensure requirements, board certification goes "above and beyond" basic licensure, Dr. Chaudhry said.

For the hundreds of thousands of physicians who aren’t engaged in some type of maintenance of certification process, the FSMB is working with states to develop alternative pathways to demonstrate ongoing clinical competence.

The timeline for the new requirements is fairly long, Dr. Chaudhry said. The FSMB is recommending that state medical boards implement the new approach in phases that in total could take up to 10 years. The first step for any state medical board that plans to go forward with maintenance of licensure is to spend the first year educating physicians, the public, and lawmakers about what is planned and why. And each of the three components of the process should take another 2-3 years to implement, he said.

"The vast majority of physicians are already doing things to stay up to date," Dr. Chaudhry said. "In that sense, [maintenance of licensure] is simply a means by which those physicians can demonstrate what it is that they are doing."

Dr. Whitehouse, who also serves on the FSMB’s implementation group on maintenance of licensure, agrees that the process will not be onerous for physicians who are making an effort to keep their clinical skills current.

Ohio is one of a handful of state medical boards that already has plans to move forward with maintenance of licensure. Mr. Whitehouse said that the medical boards have a responsibility to the public to make relicensure more meaningful. But making the process more robust is also beneficial to physicians because the medical board then becomes a reliable resource where patients can get objective assessments based on practice data, he said, rather than relying on anecdotal reports.

State medical boards are eyeing ways to overhaul the relicensure process so that it better measures a physician’s efforts to stay abreast of clinical developments.

Currently, while the public assumes that state licensure means that a physician remains competent, that’s just not the case, according to Richard A. Whitehouse, the executive director of the State Medical Board of Ohio.

"There is really no measure once someone is initially licensed and has met the threshold requirements for licensure," he said. "Absent CME requirements, there’s really nothing you can point to, to say that this person is maintaining their competency."

Officials involved in the redesign process, however, emphasize that the new requirements won’t be a burden on practicing physicians and that most doctors are already doing enough to meet the standards under development.

The Federation of State Medical Boards (FSMB), which represents the nation’s state medical boards, has been promoting the need to make relicensure a more robust process for several years.

Last spring, the organization’s House of Delegates approved a framework that lays out what the maintenance of licensure process would look like in general. And over the past few months, an implementation group made up of physicians and medical board officials has been filling in the details.

The expectation is that new maintenance of licensure requirements will involve three major components: a reflective self-assessment that calls for physicians to complete a certain number of accredited continuing medical education courses; an assessment of knowledge and skills, which could be a formal exam; and some measurement of performance in practice, in which physicians would compare their practice data to those for peers and to national benchmarks.

Dr. Humayun Chaudhry, president and CEO of the FSMB, said that one of the goals in redesigning the relicensure process is to minimize the burden on practicing physicians. To that end, the FSMB implementation group’s draft report calls on state medical boards to accept participation in maintenance of certification through the American Board of Medical Specialties, or osteopathic continuous certification through the American Osteopathic Association, as substantially meeting the requirements for maintenance of licensure. "That’s a big advance because a significant plurality of physicians are involved in those programs," Dr. Chaudhry said.

More than 300,000 physicians are engaged in maintenance of certification through the various boards of the American Board of Medical Specialties, and that number increases by about 50,000 physicians each year, according to Dr. Kevin B. Weiss, ABMS president and CEO.

Officials at the ABMS have been working closely with states for years on the issue of maintenance of licensure and plan to continue to be involved as states begin to pilot the concept over the next several months to ensure that board-certified physicians aren’t asked to do any "double work," Dr. Weiss said.

"We’re going to be very active in trying to help our physician community on a state-by-state basis," he said.

Officials at the FSMB are being careful to point out that maintenance of licensure and maintenance of certification are not meant to be equivalent. While maintenance of certification and osteopathic continuous certification could comply with the more robust relicensure requirements, board certification goes "above and beyond" basic licensure, Dr. Chaudhry said.

For the hundreds of thousands of physicians who aren’t engaged in some type of maintenance of certification process, the FSMB is working with states to develop alternative pathways to demonstrate ongoing clinical competence.

The timeline for the new requirements is fairly long, Dr. Chaudhry said. The FSMB is recommending that state medical boards implement the new approach in phases that in total could take up to 10 years. The first step for any state medical board that plans to go forward with maintenance of licensure is to spend the first year educating physicians, the public, and lawmakers about what is planned and why. And each of the three components of the process should take another 2-3 years to implement, he said.

"The vast majority of physicians are already doing things to stay up to date," Dr. Chaudhry said. "In that sense, [maintenance of licensure] is simply a means by which those physicians can demonstrate what it is that they are doing."

Dr. Whitehouse, who also serves on the FSMB’s implementation group on maintenance of licensure, agrees that the process will not be onerous for physicians who are making an effort to keep their clinical skills current.

Ohio is one of a handful of state medical boards that already has plans to move forward with maintenance of licensure. Mr. Whitehouse said that the medical boards have a responsibility to the public to make relicensure more meaningful. But making the process more robust is also beneficial to physicians because the medical board then becomes a reliable resource where patients can get objective assessments based on practice data, he said, rather than relying on anecdotal reports.