ILLINOIS MALPRACTICE: Doctors, lawyers and myths Wednesday, May 18, 2005 EVERYONE KNOWS that courts in Madison and St. Clair counties are judicial "hellholes" where juries return huge medical malpractice awards that are causing doctors to flee the state. The problem with this conventional wisdom is that it's based on well-cultivated myths - myths used to justify tort "reform" bills in the Illinois legislature that would impose unfairly low caps on victims of medical malpractice. A study of jury verdicts in Madison and St. Clair counties by Duke University law professor Neil Vidmar found that there were only 11 jury verdicts for victims of medical malpractice between 1992 and 2005. Only two awards exceeded $1 million, and one of those was thrown out on appeal. While Madison County deserves its reputation for mishandling class-action and asbestos cases, Mr. Vidmar found "no evidence to support the perception" that malpractice juries award "outrageous" verdicts. The study, performed for the Illinois State Bar Association, did not include out-of-court settlements, which are more numerous than jury verdicts. Still, it undermines the claim that doctors have to settle cases to avoid unreasonable jury awards. The Illinois Civil Justice League, a business group that lobbies for tort reform, claims that malpractice lawsuits shot up from 2000 to 2003. But those numbers hardly are persuasive. The number of malpractice cases filed in Madison and St. Clair counties increased to 108 in 2003 from 96 in 2000 - at 13 percent, a much slower rate of increase than other civil cases. And while the league speaks of the "astounding" number of doctors sued, that number increased only to 264 from 232. Doctors and their allies in the insurance industry claimed for a time that insurers in Illinois were paying out more than they were collecting in premiums. In 2002, they paid $1.47 in claims for every $1 that they collected. But things have changed. In 2003 and 2004, the biggest Illinois malpractice insurer, ISMIE Mutual Insurance Co., collected twice as much in premiums as it paid out in claims. What do all these numbers say? They suggest that the medical malpractice problem in Illinois is at least as much a result of the boom and bust of the insurance cycle as the court system. One would expect doctors seeking lower malpractice rates to be as interested in insurance reform as tort reform. But Dr. Craig A. Backs, president of the Illinois State Medical Society, says the group opposes the "onerous" insurance provisions that are part of the malpractice legislation now before the legislature. Dr. Backs' view would seem surprising, except that the doctors and insurers are in bed together. The Illinois State Medical Society established ISMIE and the two issue joint press releases. The "onerous" reforms that the two groups criticize are actually modest changes. House Bill 4074, sponsored by Rep. Thomas Holbrook, D-Belleville, allows the release of actuarial data to the public and provides for public hearings on large insurance rate increases. California has more stringent insurance regulation, which seems to have held malpractice insurance rate increases in check better than damage caps in other states. Some of the tort reforms in the Holbrook bill make sense by encouraging settlements, protecting doctors' personal assets and requiring that expert witnesses be specialists in the same field as the defendant. But the caps on noneconomic damages for pain and suffering are absurdly low - $250,000 for doctors and $500,000 for hospitals. When a doctor fails to detect a detached retina or mistakenly removes a breast, that's simply not enough money to compensate the victim for a life of blindness or disfigurement. Doctors deserve relief from high malpractice insurance costs, and so do the people of southern Illinois who see doctors leave the area. But the relief should come from a comprehensive bill that includes stricter discipline of doctors, insurance reform and improvements in civil justice.