Doctors flee Illinois due to malpractice policy

Half of all graduating medical residents or fellows trained in Illinois leave the state to practice medicine elsewhere, in large part due to the medical liability environment in Illinois, according to a new study from Northwestern University Feinberg School of Medicine in Chicago. The study warns Illinois will face a critical physician shortage — especially in rural areas — if new strategies aren't adopted to stem the exodus.

Many of those who leave are just heading across the border to Wisconsin or Indiana, says Russell Robertson, MD, a lead study author and professor and chair of family and community medicine at the Feinberg School and of family medicine at Northwestern Memorial Hospital.

"Many of these new graduates cite Illinois' toxic medical malpractice environment as a major reason," Robertson says. "The Illinois Supreme Court's decision to lift the liability caps seems to send the message that the potential for litigation supersedes the need for residents of Illinois to get needed health care."

With the national shortage of physicians, Illinois must change its malpractice policies and improve recruiting to remain competitive with other states, the study says. The situation will become more critical as the implementation of health care reform and aging Baby Boomers' medical needs escalate the demand for health care, Robertson says. Compounding the shortage, more doctors nearing retirement age are in general internal medicine, he says, while newly graduating doctors are more likely to be specialists.

The 2010 Illinois New Physician Workforce Study surveyed 561 graduating Illinois medical students in the spring of 2010. It examined graduating residents' and fellows' plans for entering the workforce and the reasons for their choices. The study was commissioned by Feinberg in partnership with the Illinois Hospital Association and the Illinois State Medical Society.

It is no shock that Illinois is losing its new doctors, says Steven M. Malkin, MD, president of the Illinois State Medical Society and an Arlington Heights internist.

"If a graduating resident sets up shop in any of our neighboring states, the liability premiums will be about a third to half of what he or she would pay in Illinois," Malkin says. "Six-figure medical education debt is the norm for many new doctors. Graduates feel it often doesn't make sense to stick around, unless they have a strong Illinois family connection."

Malkin says the study points out the urgent need for policy-makers to understand the importance of Illinois having a practice-friendly environment that encourages physicians who are educated and trained in Illinois to stay there.

One way to retain new doctors is to help them find jobs in Illinois, says Maryjane Wurth, president of the Illinois Hospital Association. The state has a healthy physician job market, but many new graduates don't know where to look, she says. Robertson points out that many young physicians rely on Google and other Internet searches to find a job, whereas health employers are not using those options as widely as they could.

Illinois also needs to better align its medical education system with physician supply needs to better serve patients, Wurth said. "Many hospitals across Illinois have already been facing physician shortages, especially in rural and underserved areas," she says.

The full study is available at http://www.ihatoday.org/uploadDocs/1/phyworkforcestudy.pdf.