Theo Mellion, M.D., once saw himself as a pioneer in downstate Illinois, but now he's fed-up and heading west for his future.
For the folks left behind in Carbondale, the neurosurgeon's departure could be a matter of life or death.
Mellion called from a hotel in St. Louis, where he, his wife and 3-year-old daughter were sojourning on the way to Wichita, Kan.
He's a poster doc this week for the national medical malpractice problem.
Mellion will be making his second job-hunting visit to Kansas since announcing in March that he would close his thriving neurosurgery practice in Carbondale because of soaring medical malpractice insurance costs.
Mellion founded the practice seven years ago and recruited Sumeer Lal, M.D., to join him. The partners, the only two neurosurgeons in southern Illinois south of Springfield, performed 600 to 700 surgeries a year.
"I went there as a pioneer and we were run out of town like lepers by the insurance companies and the trial lawyers," Mellion said.
Tuesday, in response to the neurosurgeons' departure and the fear that other doctors would follow, Carbondale's City Council passed an ordinance capping noneconomic damages in medical malpractice cases that involve events that took place within the city.
Meanwhile, in Springfield, Ill., Gov. Rod Blagojevich and legislative leaders held "a very lengthy meeting" to discuss medical malpractice and were set to meet again this afternoon, said Rebecca Raush, a Blagojevich spokeswoman. Details of the discussion were not available, she said.
Mellion said he and Lal had a clean record, with no medical malpractice judgments against them, but their medical malpractice insurance carrier refused to renew their coverage. The doctors were rejected by several others carriers, but eventually obtained some quotes. "We were looking at $200,000 to $300,000 a year, each," Mellion said.
Mellion and Lal decided to leave. Both stopped seeing patients in May. Lal moved his practice to Greenwood, S.C.
Meanwhile, Mellion sold his house and began his search, scratching the 19 states, in addition to Illinois, that have been deemed by the American Medical Association as in a malpractice crisis.
"Fortunately, as a neurosurgeon, there is a demand for our services," he said. Mellion is considering joining a group of Wichita physicians, several of whom he knows from his days as a surgical resident at Baylor College of Medicine.
Like Lal, Mellion said tail coverage was as much a factor in his decision to move as the proposed six-figure premium. Tail coverage, for future liability, generally runs two to two-and-a-half times the final-year premium, he said.
Lal's $210,000 tail coverage was paid for him as a recruitment incentive, Mellion said
"I have to pay $230,000 out of my pocket for the privilege of leaving Carbondale," he said.
If the surgeons had waited another year to leave, their tail coverage could have zoomed above $500,000 apiece, he said. "At that point, there is nobody who's going to offer any incentive for that," Mellion said.
The graduate of the University of Connecticut School of Medicine said the move in his 13th year of surgical practice is "incredibly disruptive" for his family and professionally, but he's also concerned about its impact on the community he once served.
These days, emergency neurosurgery patients in the region are being airlifted to hospitals in Chicago, St. Louis and on one occasion Little Rock, Ark., said Tom Firestone, M.D. He is president of Southern Illinois Healthcare, a not-for-profit corporation that owns Memorial Hospital in Carbondale at which Mellion and Lal practiced. Sometimes, it's a scramble to find an opening, Firestone said.
Mellion sees danger in that arrangement, citing as an example of one of his final Illinois surgeries -- on a student from Southern Illinois University.
"About a week before we closed the practice, an SIU student came into the emergency room at five in the morning," Mellion said. The young man had hit his head, was drowsy, then became comatose, he said. It was a blood clot.
"I had him in the operating room in 30 minutes," said Mellion. If surgery had been delayed several hours finding a distant neurosurgeon, an open OR and an airlift, "that kid would have died."
Mellion says he views the malpractice reform law passed by the Carbondale City Council as a symbolic gesture, given that the Illinois Supreme Court has twice struck down state laws addressing malpractice awards.
He also was pessimistic any meaningful reforms would emerge from the state Legislature this year. "Until some high-ranking officials are faced personally with some disastrous situation, nothing is going to change," Mellion said.