Why Physicians Should Practice Medicine in Illinois

Deborah Winiger, 45, came to Illinois just prior to enrolling at Loyola University's Stritch School of Medicine and has stayed ever since.

In 2000, she established North Suburban Family Healthcare, her solo family medicine practice, in Vernon Hills, Ill., about 40 miles north of Chicago. With family nearby and a great relationship with her patients, she says it's likely that the "Land of Lincoln" will be her professional and personal home for some years to come.

"I love what I do and love my patient population, so I'll never leave to be honest," says Winiger.

But that doesn't mean there aren't parts of practicing in Illinois she would change.

For you, what is the best part of practicing medicine in the state of Illinois?

The best part I think, at least being in the Chicago suburban area, is having subspecialty care and tertiary care within a very short distance. It makes it a comfortable way to practice medicine knowing I have specialists really close by; within 15 minutes. Plus [there's a] tertiary care center within an hour [of my practice] which means, with complicated cases …you can provide better care than when you need to travel two hours to three hours.

In addition to family, the connections I've made [have kept me in Illinois]. I've been with the same hospital [Advocate Condell Medical Center] for that amount of time too. That comfort level of being familiar with a system and the service area and what's available is important.

In terms of cost of living, however, it is not the cheapest you can get in the country; it's not the most expensive either. The suburbs of Chicago are a little more reasonable. I'll be honest, if I went across the border and moved to Indiana, I could probably make the same salary, but pay a third less in terms of cost of living.

What, if anything, would you change about the climate for physicians in Illinois?

There are two things I would easily change. One is that Illinois is probably in the top five in terms of malpractice suits in the country, so it is not very physician-friendly as we have no caps on malpractice claims. In that same vein, we have a very strong trial lawyer association, which compounds that problem. That's probably the biggest issue. Colleagues of mine in multiple specialties, they can't get partners because of the malpractice issue. Some have actually moved across the border to Wisconsin because the cost of malpractice [is cheaper]. It has gotten a bit better here, but still a very litigious state. I pay probably in the upper echelon in the country for malpractice [coverage].

Plus, we have a nearly bankrupt state …we are on the brink anyway. So that doesn't help, unfortunately. [The state legislature] took money out of the reserves for physician licensing, siphoning it off over several years. Now, fees for licenses are at least two-and-a-half times more than what they were previously.

[Editor's Note: In March 2013, the Illinois General Assembly approved a measure to raise the cost of a three-year licensing fee for physicians to $700 from the previous rate of $300. The raise was to help fund the Illinois Department of Financial and Professional Regulations, the body that licenses and disciplines state physicians.]

(read family physician William F. Hays' take on Illinois on the next page)

William F. Hays, 66, has practiced in Illinois for 33 years, both in a solo and group practice. The family physician currently practices in Herrin, Ill., in the southern region of the state and attended Northwestern University in Chicago:

For you, what is the best part of practicing medicine in the state of Illinois?

The people and communities of Southern Illinois

What, if anything, would you change about the climate for physicians in Illinois?

Illinois became a haven for malpractice attorneys in the 80s and 90s and while that has cooled off some, it is still a major issue in this state. Our premiums are higher than most of the surrounding states.

Secondly, Medicaid in Illinois is a catastrophe the way it has been allowed to function. The previous governor [Rod Blagojevich], it seemed, tried to place any and everyone on the system. This led to long payment cycles in a system that historically has underpaid for its services. When one of my Medicaid patients needs a referral to a specialist, especially one that has high malpractice overhead, it is virtually impossible to get it accomplished.

Many specialists will not accept Illinois public aid because of the poor reimbursement and risk of litigation that their respective field may have. For example, there are very few neurosurgeons in southern Illinois; most practice in the neighboring states of Missouri, Kentucky, and Indiana. They are so poorly paid by Illinois that they will not accept the patients that need their services. As a consequence, we, the primary-care physician[s], are left trying to manage a problem for which we do not have the ability to perform the surgery that might be needed. There are, of course, some who will, but they are so overburdened that they cannot accept the majority of patients who need to see them.

Also, Medicaid patients can have only four medications. While this rule may be fine for many patients, it fails miserably for those with chronic illnesses who have lost their jobs and have had to resort to Medicaid. My staff then must spend hours on the phone, filling out endless paperwork, to get a needed medication covered. It frustrates me and my staff to a point of anger. It also interferes with seeing the patients who need our presence in the exam room, or access to the care we can provide. We are too busy filling out the forms to be able to examine a patient or answer their questions and, most importantly, educate them about their illness(es).

I live two blocks from where I was raised, but if I knew 40 years ago what I know today, I would not practice in Illinois.

Illinois is a state that has a very poor business climate. It has high taxes, poor government accountability for its actions, high malpractice rates, slow payment if one gets paid for a service, and because of budgetary woes, closes needed facilities throughout the state, even more so in the southern part.

It is almost as if they salt the ground and then try to plant a garden and expect it to grow.

The people of the southern part of the state are a wonderful group of people. They are hard working and very caring people. They deserve better than their state has offered to them. I would love to see a 51st state of Southern Illinois.

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