Academic journal article Vanderbilt Law Review

"Judicial Hellholes:" Medical Malpractice Claims, Verdicts and the "Doctor Exodus" in Illinois1 2

Academic journal article Vanderbilt Law Review

"Judicial Hellholes:" Medical Malpractice Claims, Verdicts and the "Doctor Exodus" in Illinois1 2

Article excerpt

I. ILLINOIS AS A REPORTED "JUDICIAL HELLHOLE" FOR PHYSICIANS

Beginning about the year 2000, physicians around the nation experienced an explosive jump in their professional medical liability insurance premiums.3 The state of Illinois has been identified as one of the "crisis" states by the American Medical Association ("AMA") insofar as cost and availability of liability insurance is concerned.4 Madison and St. Clair counties, just across the Mississippi River from St. Louis, have garnered particular attention, acquiring the label "judicial hellhole" for medical malpractice claims.5 The notoriety is so great that President Bush visited Madison County in January 2005 as part of his campaign for a nationwide $250,000 cap on pain and suffering for medical malpractice jury verdicts.6 The claims are not limited to these two counties, however. In the greater Chicago area, in particular Cook and DuPage counties, similar claims have been made about excessive jury verdicts and their effect on professional liability insurance.7

Accompanying the claims of runaway juries are reports of an exodus of doctors from Illinois to escape the "abusive litigation climate."8 While these reports have been applied to Illinois as a whole without specific statistics about the size or nature of the exodus, various numbers have been obtained from Madison and St. Clair counties. In November 2003, an article in the Belleville News Democrat reported that fifty-nine doctors had left one hospital.9 In April 2004, another article stated that "[a]t least 60 doctors in the past two years have left or announced plans to leave Madison and St. Clair counties."10 In 2004, the Springfield Journal-Register, the St. Louis Post-Dispatch, and the Wall Street Journal variously reported that the two counties had lost a total of 160 or 161 doctors.11 In March 2005, the News Democrat upped its earlier figure to 136,12 based upon a study by two business professors from Southern Illinois University, Edwardsville, who estimated their figures from surveys of area hospitals and counts of doctors' offices in the area.13 As late as June 9, 2005, the figure had grown to 180 physicians leaving Madison and St. Clair counties.14

The controversy in Illinois is part of a contentious nationwide debate about the causes and consequences of the undisputed problems regarding availability and cost of malpractice insurance. While consumer groups and trial lawyers insist that the cause of the premium jumps lies with the business cycle in the insurance industry, physician groups, hospitals, liability insurers, and business organizations blame the tort system.15 In Illinois, as in other states, these latter groups argue that increasingly frequent claims and increasingly large jury verdicts, particularly the "pain and suffering" component of awards, have resulted in excessive payouts. Industry groups argue that such payouts result not only from jury verdicts directly but also from the "shadow effect" of large verdicts arising when health care providers settle malpractice claims for higher amounts than are warranted, if warranted at all, out of fear of exposure to even larger jury awards.16

This Article examines the claims about jury verdicts and the medical malpractice climate in Illinois. We first examine claims and jury verdicts in the especially notorious region - the "judicial hellhole" -comprised of Madison and St. Clair counties. Our data are derived from the Southwestern Illinois Jury Verdict Reporter, reported in both Westlaw and Lexis, which covers these two counties. The data for Madison County were checked by a direct examination of the files in the Madison County Courthouse. We then present a similar analysis of the greater Chicago area involving Cook and DuPage counties. Our data for this research are derived from the Cook County Verdict Reporter, supplemented by additional sources in Westlaw and Lexis databases and brief telephone interviews with lawyers to confirm missing information about settlements. …

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