Something heartbreaking happened in Monroe County in 2023.

After decades of delivering babies, Monroe County Hospital closed its labor and delivery unit. For generations of families, the hospital had been the place where their children entered the world. Suddenly, expectant mothers faced the prospect of traveling dozens of miles to another hospital to give birth.

And Monroe County is not alone. Hospitals across Alabama – from Grove Hill to Shelby County to Mobile – have closed their labor and delivery units in recent years.

Imagine being an expectant mother in Alabama, knowing that when labor begins, the hospital where you planned to deliver your baby can no longer care for you.

Or imagine being a physician who has spent a career caring for patients in a community, only to see an essential medical service disappear.

Hospital labor and delivery units close for a variety of reasons, including financial pressures and staffing challenges. But what happened in Monroe County and other communities illustrates a larger problem facing Alabama. Access to healthcare is becoming increasingly difficult. Unless we make Alabama a more attractive place to practice medicine, the situation will only get worse.

As a physician and president of the Medical Association of the State of Alabama, I am deeply concerned about our ability to recruit and retain the doctors our communities desperately need.

We ask young physicians to build their careers here. We ask experienced physicians to remain where their services are desperately needed. But are we giving them enough reasons to stay or too many reasons to leave?

There is no single reason for Alabama’s healthcare access challenges. But one is Alabama’s medical liability climate, where physicians and medical practices face the possibility of extraordinarily large malpractice verdicts.

Earlier this year, a Mobile County jury returned a $50 million verdict against a cardiologist and his medical practice following the tragic death of a patient.

The verdict was later reduced to $6 million, but the case exposed a problem that should concern every Alabamian who depends on having a doctor nearby.

The Mobile cardiology practice also provides care in rural Washington County, a medically underserved area where access to specialists is already limited.

According to information presented during the case, the enormous financial exposure threatened the practice’s future. Physicians considered leaving or retiring. Investments in medical equipment were put on hold. The continued availability of care in rural communities was at risk.

Think about what that means for patients.

What happens when someone in a rural community experiences chest pain and the nearest cardiologist is no longer available? What happens when an elderly patient must travel hours for an appointment that once required a short drive?

What happens when a community loses its physicians and cannot recruit replacements?

In reducing the verdict, the judge recognized that the consequences could extend far beyond the physicians involved. He found credible evidence that the cardiology practice could lose several physicians, warning that such a development “would have critical consequences for the provision of healthcare in Mobile and the surrounding region.”

Importantly, the judge also considered the potential impact on those he called “innocent third parties” – the patients.

That recognition underscores something we cannot afford to overlook: The consequences of our medical liability climate ultimately affect patients who simply need access to care.

Patients and families who suffer harm deserve accountability. Nothing about improving Alabama’s medical liability environment should diminish the importance of patient safety or the responsibility physicians have to those entrusted to their care.

But we must also recognize that our legal environment has consequences for patients and doctors who have nothing to do with a particular lawsuit.

Consider a young physician completing residency training.

That physician may have spent more than a decade preparing for a medical career and accumulated substantial educational debt. Now comes a decision about where to establish a practice, raise a family and build a future.

Why choose Alabama if practicing medicine here means confronting extraordinary liability risks, particularly when other states offer a more predictable environment?

Alabama already struggles to compete for physicians. Reimbursement rates are often inadequate, administrative requirements consume time that should be spent with patients, and insurance-related obstacles make running a medical practice increasingly difficult.

Our medical liability climate adds another powerful reason for physicians to practice elsewhere.

We should be learning from states that have confronted similar challenges.

Texas faced a serious physician recruitment and retention problem before adopting medical liability reforms in 2003. In the years that followed, the state experienced substantial growth in its physician workforce, including specialists practicing in underserved communities.

Alabama cannot afford to ignore that lesson.

We invest in medical education, expand residency programs and encourage young people to pursue careers in medicine.

But what good is training more physicians if we cannot persuade them to stay?

Access to healthcare is not a Republican issue or a Democratic issue. It is an Alabama issue. Regardless of political affiliation, we all want our families and neighbors to have access to quality medical care when they need it.

But until state leaders seriously address Alabama’s medical liability climate, we will continue giving physicians reasons to practice somewhere else.

Legal reform is not about protecting doctors from accountability. It is about protecting patients’ access to doctors.

Nina Ford Johnson, M.D., is a Mobile pediatrician who serves as president of the Medical Association of the State of Alabama.