The Doctor Won't See You Now

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Dr. Alexander Sosenko is proud of his skills, but these days they don't seem to be the ones he needs to keep his medical practice going. A pulmonologist for 19 years, he knows just about everything there is to know about the lungs and is cherished by patients for his concerned, direct manner. But by his own admission, he's not great at lobbying. And, unfortunately, that's how Sosenko, 49, has lately been spending much of his time--circulating petitions at the local hospital, pleading with politicians for help. He has spent sleepless nights worrying that he may have to uproot his wife and three children from their home in Joliet, Ill., or else give up the profession he loves--all because he can't find affordable malpractice insurance.

A few months ago, Sosenko and the five other doctors at the practice he founded, Midwest Pulmonary Consultants, learned that their malpractice insurer, American Physicians Capital, would not be renewing their policy when it expired at the end of March. They weren't exactly shocked. Over the past two years, insurers of doctors in Illinois, worried by a rise in malpractice awards by juries in the state, have dwindled in number from more than two dozen to six. But then it got personal. Sosenko and his partners discovered that their insurer was not leaving Illinois entirely but was limiting its exposure. Although Sosenko and his colleagues had not lost or settled a single lawsuit over the years--an impressive record in this litigious age--they are named in a couple of cases that have been grinding through the courts since the late 1990s. Sosenko and his colleagues have denied all the allegations and refuse to settle.

When the doctors started looking for an insurer to replace APC, none of the mainstream malpractice insurers offered coverage. One smaller firm came up with a package for nearly $100,000 a doctor (up from about $14,000 only two years earlier), plus $500,000 a year for "tail" coverage, to insure the practice for any suits that might arise from care provided before the new policy took effect. The doctors couldn't afford it. So after one of them left the practice to try to go it alone, the rest enlisted their state senator, who persuaded their original carrier to give them an extension--which expired at the end of last week. What next? Will they change specialties? Will they change addresses to a less litigious state? And what of their 6,000 patients, who would have to drive an hour to the nearest lung specialist, in Chicago? "We doctors can move on," says Sosenko, tilting back in his office chair. "But our patients can't."