Graduating Doctors Flee Illinois, Cite Malpractice Policy

Nov. 11, 2010, CHICAGO --- 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. The study, the first to examine the state's supply of new physicians, warns Illinois will face a critical doctor 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," said Russell Robertson, M.D., 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. 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. Compounding the shortage, more doctors nearing retirement age are in general internal medicine, 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 our new doctors," said Steven M. Malkin, M.D., 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. 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."

"This study points out the urgent need for policymakers to understand the importance of Illinois having a practice-friendly environment that encourages the many thousands of physicians who are educated and trained in Illinois to stay here," said Maryjane Wurth, president of the Illinois Hospital Association.

One way to retain new doctors is to help them find jobs in Illinois. The state has a healthy physician job market, but many new graduates don't know where to look. "To our surprise, a primary search technique that young physicians are using to find jobs is Google," Robertson said. "We need to centralize their job search and improve the physician recruitment process." 

Another benefit of retaining new physicians: more jobs for Illinois and dollars infused into local communities. A recent Oregon study showed each physician's practice supported 12 to 48 jobs.

Organizers of the new Illinois study urge the development of an Illinois Physician Workforce Institute to collect data and information on the state's supply of physicians and to serve as a clearinghouse for Illinois physician recruitment. The data would guide policymakers and health care leaders as they make decisions about health care delivery, including malpractice issues. Earlier this year, the Illinois General Assembly adopted a resolution calling for such an institute.

Illinois lags behind other states in its efforts to collect numbers of health care providers, noted John Gatta, the other study lead author and director of research in family and community medicine at Feinberg.

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 noted.

"The current gap in providers is huge," Robertson said. "When health care reform hits, the gap will be insurmountable. If the health care work force in Illinois isn't healthy, folks will end up in someone's emergency room."

The study calls for legislators to:

1) Create an Illinois Physician Workforce Institute.

2) Fight for medical malpractice tort reform.

3) Develop strategies to retain Illinois medical residents and fellows; investigate medical school and residency admission policies to align recruiting efforts to be more favorable to those who are likely to practice in Illinois.

4) Centralize the Illinois physician job search and recruitment process.

5) Promote physician opportunities in rural communities and provide more incentives to attract physicians to practice in those communities.  

View the full study at

Marla Paul is the health sciences editor. Contact her at [email protected]