Oct. 25 -- Bryanna Baker, 42, moved from New Mexico to Virginia because she was the victim of medical malpractice that changed her life so much she couldn't handle the New Mexico altitude.
Meanwhile, last week Troy Clark, the president and CEO of the New Mexico Hospital Association, got a call from a family who needed help. Their baby needed to see a pediatric gastroenterology specialist within two weeks, but they couldn't get an appointment until February.
New Mexico is facing a shortage of doctors and other health care providers. Officials said there are several factors that are hindering the state's health system, including the high percentage of patients on Medicaid, recent changes to medical malpractice laws that have made insurance expensive and a tax system that makes operating a health care business in New Mexico less lucrative than in other states.
Think New Mexico, a result-oriented think tank, recently published a report titled, "How to Solve New Mexico's Health Care Worker Shortage."
Citing data from the New Mexico Health Care Workers Committee, the report found that the number of primary care physicians in the state dropped from 2,360 in 2017 to 1,649 in 2021, a 30% decline.
And it's not just primary care doctors that are lagging. Similar workforce reports show New Mexico is short thousands of nurses and emergency medical technicians compared to national benchmarks, and the state is facing shortfalls of hundreds of physical therapists, pharmacists, physicians' assistants and certified nurse practitioners.
Dr. Art Weinstein, who was one of the founders of Eye Associates of New Mexico in 1976, said it has gotten increasingly difficult to recruit doctors to New Mexico in the last decade. He said his clinic is booked out for several months for procedures like cataract surgery.
"Recruiting physicians to New Mexico is hard," Weinstein said. "It's changed over the last 10 years dramatically."
Think New Mexico's report made several recommendations that the group plans to advocate for in the 2025 Legislature. Those policies include:
-- Reform the state's medical malpractice laws by capping attorney's fees and raising the legal standard for punitive damages, among other things.
-- Join interstate health care worker compacts so physicians and providers can more easily practice in New Mexico.
-- Create a centralized credentialing system to reduce administrative tasks.
-- Make the student loan repayment plan more affordable.
-- Make the state's tax policies friendlier to medical businesses.
In 2006, Baker, then 24, started having shortness of breath and developed a crushing chest pain.
"Like an elephant or a bus sitting on my chest," she said.
Pregnant, Baker went to Miners' Colfax Medical Center in Raton. She waited hours before a physician diagnosed her with heart burn over the phone. The doctor was actually working in a clinic and not at the hospital at the time.
When her symptoms got worse, she was transferred to Alta Vista Regional Hospital in Las Vegas, and then to University of New Mexico Hospital, where doctors determined that she had been having a massive heart attack for three days.
"My heart was permanently damaged to the point that I'm going to need one or two heart transplants in the near future," she said. "I'm sharing my story today so that I can protect others like me who are harmed in a system that puts money over patient safety."
Baker ended up losing her child and can no longer have children. She moved to Richmond, Virginia, because she could no longer handle the New Mexico altitude. She lives on disability with just 10-15% of her heart function.
Traveling is a struggle, so she rarely sees her family. She's homebound for hours every day because she requires a daily diuretic that leaves her running to the bathroom for three hours. She often feels bad in the mornings and cancels any plans.
"I hope that by talking to you and other people that something will change for the better for patients in New Mexico," Baker said. "I don't wish this life on anyone."
Baker reached a settlement as part of a medical malpractice lawsuit she filed over her case, which at the time was capped at $600,000 plus medical expenses. The terms of her settlement prohibit her from discussing details of the outcome.
Changes to state law
In 2020, the New Mexico Legislature voted to increase the cap on medical malpractice claims.
Theresa Hasci is a New Mexico attorney who defends patients harmed by medical malpractice. She is also a member of the New Mexico Trial Lawyers Association, which advocated for the changes. The 2024 cap is $5 million for hospitals and health systems and $750,000 for individual physicians, Hasci said.
"When you look at somebody like Bryanna, who lost a child and her ability to have children, lost her heart function, if you look at what the Medical Malpractice Act had previously done, it basically took away accountability for multibillion dollar corporations," she said.
A medical malpractice claim can be a life-changing experience for a patient and their families. Hasci said she has a client, Hope, who was misdiagnosed with an ectopic pregnancy in Alamogordo. A doctor gave her methotrexate to terminate the pregnancy. The result was that the child, now 3 years old and just 17 pounds, was born with severe birth defects.
"Those two people ... will have to live with the consequences of that doctor's actions for the rest of their lives," Hasci said. "That case is currently pending and (the hospital) is arguing her remedy should be reduced to not nearly enough to compensate this child."
But physician groups argue that lifting those caps on medical malpractice payouts and the high number of malpractice lawsuits filed in the state have significantly increased the cost of purchasing the insurance.
Shortages throughout the state
Clark, with the New Mexico Hospital Association, which represents 47 hospitals in the state, said a health care worker shortage is affecting all aspects of health care in the state. Rural and urban hospitals are struggling to find workers, and primary care doctors and specialists are in high demand.
He said there are several factors that have caused the state to lose physicians and health care workers in recent years. The COVID-19 pandemic burned out many providers, and they left the industry. Fewer people entered medical and nursing schools during the pandemic.
The Think New Mexico report found that New Mexico had the second-highest rate of medical malpractice claims in the U.S. The caps have also increased, which has made medical malpractice insurance for providers more expensive.
Additionally, around 42% of patients in New Mexico have Medicaid, which doesn't compensate health systems and medical offices as much as commercial insurance. Health care business in the state also have to pay gross receipts taxes, which the vast majority of states don't require.
Clark said he'd like to see the state make changes to address the shortfalls. He said he understands why many New Mexicans wouldn't be sympathetic to the state subsidizing efforts to recruit and retain doctors.
"I understand that in a poor state like New Mexico, it's difficult to offer tax credits to physicians, who we would consider wealthy," Clark said.
He said there's a big difference between bad medical outcomes and medical malpractice. He said judgements and financial awards against doctors will follow them for their entire careers.
Think New Mexico reported that in 2022 New Mexico had the largest medical malpractice insurance loss per state
"Just being sued causes extreme stress and anxiety on a physician," Clark said. "If there is a judgement, settlement or award against a physician, it stays on their record for their entire career."
Ongoing debate
Clark said the doctor shortage could continue into the future.
"The trial lawyers have been successful in telling people that the medical malpractice environment in the state is totally disconnected from our recruit and retention," Clark said. "My answer to that is, then why does it keep getting worse?
"If you're a physician coming out of residency, if this is what you have to look forward to, and you have other options in other states, it's kind of a no-brainer."
Danielle Casey, the president and CEO of the Albuquerque Regional Economic Alliance, said the state's health care system can affect economic development.
"It's a chicken or an egg situation. If we don't figure out how to remove obstacles to bringing in employers that deliver quality jobs, we're never going to get to where we need to be in health care," she said. "If you can lower your percentage of people on Medicare and Medicaid, then (health care businesses) will be more profitable and they can actually attract health care providers."
Annie Jung, the executive director of the New Mexico Medical Society, said data shows that every physician needs 18 support staff.
"These are 18 well-paying jobs, paying tax into the state system," she said.
The New Mexico Trial Lawyers Association argues that the state has taken several steps to support medical and health care professionals in recent years.
For example, this year, the state more than doubled the number of physicians who qualify for the Rural Health Care Practitioner Tax Credit and created an additional gross receipts tax deduction. Lawmakers also increased Medicaid reimbursements and increased general appropriations to small and rural hospitals.
Hasci said there are solutions to a workforce shortage.
"I want to see us subsidize health care providers and stop subsidizing multibillion dollar corporations," she said. "We can pay off student loan debt. We can provide housing to doctors to locate here. There are solutions."