While other doctors are battling escalating malpractice insurance premiums by walking off their jobs and calling for caps on damages, Illinois neurosurgeons are taking a different tack.
Stephen Ondra, M.D., president of the Illinois Neurosurgical Society, says his group will try to negotiate directly with doctors' arch-foes, the trial attorneys, and pitch to them novel reforms such as limiting use of physicians' personal assets to pay damages--a pressing problem in his specialty.
Ondra says that neurosurgeons pay the highest malpractice premiums of any specialty, with rates now at $150,000 a year or more in Illinois, and that payouts now often exceed insurers' coverage limit of $1 million per case.
Earlier this month, he says his members overwhelmingly voted to walk off their jobs to protest premium rises of 15% to 20% per year in the past two years, but rescinded that decision when attorneys advised them the society could be violating antitrust laws.
Ondra says his group does not oppose caps on noneconomic damages, the top aim of most of organized medicine these days, but he reports that they have little chance of passage in Illinois, where they have been struck down before as unconstitutional.
He says these roadblocks led the society to think of novel approaches, such as directly facing off with the trial attorneys, who typically have not been sympathetic to any kind of tort reform.
He concedes that he has not yet asked the lawyers for a meeting but says: "It is in the trial attorneys' interest to solve the worst parts of the problem. If they create an environment where it is difficult to practice and doctors leave the state, there will be shortages, and eventually trial attorneys will get legislation that is very unfavorable to them."
In a recent poll of his members, Ondra says one-third said they are considering retiring or cutting back their practices, and more than half said they may leave the state
Ondra says the neurosurgeons decided to ask for limits on use of doctors' personal assets because delving into them has become a common phenomenon. In Illinois in the past 12 months, he says, four judgments against neurosurgeons exceeded the coverage limit of $1 million per case, which is typical for most malpractice insurance policies.
In those cases, he says, neurosurgeons have been advised to file for bankruptcy and even divorce their wives so that a wife's assets could not be taken.