HONOLULU -- Hawaii is facing a shortage of doctors. Physicians say they cannot afford to practice medicine so they are leaving the state at an alarming rate.

Hawaii might be able to learn some lessons from Texas.

Dr. David Teuscher is in an orthopedic specialist in Texas. He was at a forum explaining to Hawaii doctors how Texas placed caps on damages in lawsuits, reformed civil litigation and saved the Texas health care system.

Hawaii is losing doctors at an alarming rate. Many doctors say they cannot afford malpractice insurance. They say paperwork is putting them out of business, and they claim they do not get reimbursed enough by insurance carriers.

Texas faced the same problems several years ago.

"We kept reminding our Legislature 'Hey, this is bad. This is getting bad. This is getting worse," and then all of a sudden the realization that our entire system was about to implode," Teuscher said.

Doctors in Hawaii say lawmakers have not addressed the issues. In Texas, they did.

"And we came together Republicans, Democrats, rural, urban and said, 'let's fix it. Let's do it right,'" Teuscher said.

That is the message brought to Hawaii.

"Tort reform does work. Placing caps does work, and the Legislature keeps coming back. Well, maybe it'll decrease premiums. Maybe it won't they've proven it does work," said Linda Rasmussen, of the Hawaii Medical Association.

Teuscher said insurance premiums are half what they were in 2003. He said there is also no shortage of doctors in Texas. So, by the lawmakers making a better business climate, the health care system recovered, he said.