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Prior reports have confirmed that comprehensive tort reform in Texas (2003) has resulted in fewer malpractice claims and lawsuits against physicians and a reduction in the cost of both insurance premiums and the associated litigation fees. We hypothesize that Texas medical liability reforms have achieved the Legislature’s intent of improving statewide access to critical health care services. The positive impact on physician manpower has been monumental with 21,000+ new medical licenses issued since tort reform (↑62% for past 3 years compared to the 3 years pre-tort reform). The number of new licenses issued by the Texas Medical Board in 2008 was 3,600 (a record high) compared to 2000 for the year 2001 (lowest for the preceding 10 years). Eight in ten Texas hospitals have reported that it is now easier to recruit medical specialists in the wake of tort reform. Since 2003, 218 new obstetricians have come to Texas with 27% practicing in medically underserved areas and all 254 counties now have at least one obstetrician. Similar increases have occurred in neurosurgery, emergency medicine, cardiology, cardiovascular surgery, orthopedic surgery, pediatrics, and geriatrics. Eleven counties have their first general surgeon and 24 counties have added at least one general surgeon. The Rio Grande Valley, a former hotbed of medical malpractice claims, has seen an influx of 220 physicians. Although impossible to document except from medical society hearsay, there has been a positive manpower impact from the physicians who reversed their decision to retire as a result of tort reform implementation. The Texas Medical Association has estimated that this additional physician manpower since tort reform has provided an additional six million patient visits. Texas hospitals have saved \ million /year which has allowed them to deliver more charity care (↑ \ million / year), expand patient safety programs (↑58%), subsidize shortfalls in government programs such as Medicaid (↑46%), raise salaries for nurses and increase nurse staffing (↑46%), and maintain, improve or add new equipment (↑39%). In conclusion, medical liability reform enacted by the Texas Legislature in 2003, has afforded Texans an increased ability to access health care and would appear to be an ideal tort reform template for adoption by the other 49 states.