I was elected as the president of the Illinois State medical Society last April, and since then I’ve had many opportunities to travel the state talking health care and how to keep Illinoisans well.

While on the road for ISMS I’ve met with many physicians and health care professionals.  I’ve also met with members of the public whose only involvement with health care is a visit to their family physician.

Recently I had a three day stretch of travel through southern Illinois that consisted of several meetings and speaking engagements.  I ended my tour with a strong impression of the bond that exists between health professionals and the people of southern Illinois. 

When not serving in my role as president of ISMS, I practice internal medicine in Arlington Heights, which is about 45 minutes north of Chicago. Because of the population density where I work, doctors can sometimes come and go without being noticed.  This is in sharp contrast to many of the communities I visited recently, where local people and their doctors are involved in each other’s lives on a daily basis.

I toured a beautiful hospital addition that was built with strong community backing.  On another stop I was told about two separate hospital oncology departments that shared a PET scanner.  People sometimes forget that health care is a business.  In what other business do competitors share equipment?

These are good stories and remind me of why I went into medicine.  However, not all of the news I heard during my tour was so positive.  I visited with a small group of OB/GYNs who attempted to recruit a local OB/GYN into their group.  She instead chose to practice in Indiana because of Illinois’ medical liability climate.

I also met with a group of doctors from a community that had about ten physicians providing care for the region. They expressed concern about the future of local health care availability.  Most of the local physicians are within 10 years of retirement, and they are worried about their ability to recruit replacements. One of the physicians has a son currently training to be a physician.  He said he hoped his son would come back and eventually take his place, but he wasn’t sure his son would return or what they would do to replace the other doctors.

The time has come for serious discussion about Illinois’ physician supply.  The experts are already telling us that the U.S. isn’t training an adequate number of doctors. Primary care doctors are especially needed.  American Medical News recently reported that there were 26,400 online job postings in January seeking to fill primary care positions nationwide. Many of those are for positions here in Illinois.

 A study conducted by the Northwestern University’s Feinberg School of Medicine last fall found that half of the doctors who train in Illinois don’t stay here after residency.  About two-thirds of them said our lawsuit climate was a contributing factor in that decision.  The study also found that many of the doctors who do stay are more likely to practice in more densely populated areas like I do. About 20% of patients live in rural or underserved areas, yet only 1.2% of physicians commit to practice in these areas. 

I like to tell people that they shouldn’t just take my word for it when I talk about Illinois’ medical climate.  You probably have access to your own expert; the next time you visit your doctor ask her or him what it is like to practice here.

I know I have highlighted several concerning issues, but there is some good news. Our problems can be fixed – but we need laws and policies that make Illinois a destination for doctors, not a danger zone. 

Steven M. Malkin, MD, FACP
President, Illinois State Medical Society