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However, physicians themselves deserve at least part of the blame. "Doctors," says Dr. John Walsh, 46, one of Sosenko's partners, "haven't sold themselves as a self-policing group." The vast majority of conscientious physicians have been forced to subsidize the higher insurance costs of a few incompetents. Consider this: between September 1990 and March 2003, just 5% of the doctors who have made medical malpractice payments accounted for a third of all the money paid out, according to the Federal Government's National Practitioner Data Bank.
Sosenko's crash course in law and politics is taking an emotional toll on him and his family. An avid windsurfer and science-fiction buff whose favorite books are The Hobbitt and The Lord of the Rings, Sosenko hasn't been able to enjoy himself much for the past several months. He hardly has the time or energy to play video games with his son Nick, 10. For the first time in recent memory, he has missed some of his 12-year-old daughter Teresa's afterschool volleyball games, though he still manages to take the kids to their classes at the Ukrainian cultural center on Saturdays. (The family speaks Ukrainian at home.) Sosenko has always been a bit moody. His office is littered with Tasmanian-devil toys given to him by his family, an inside joke alluding to his occasional temper. But nowadays he is regularly depressed and irritable. "Alex takes everything to heart," says his wife Maria, 46, a rheumatologist (whose malpractice premiums nearly doubled this year, from $8,592 to $15,472). "He's frantically searching for help."
With Medicare, Medicaid and HMO reimbursements falling and malpractice premiums steadily rising, Sosenko's income has dropped 40% over the past five years, to about $200,000 last year. That might sound like a lot, until you consider the 13 years he studied after high school, the debts he built up, the nights and weekends he works. As his colleague Cohan says, with only a little exaggeration, "Our income is completely controlled by the government, but we have no control on our expenses." Both men are bracing for a potentially bigger pay cut. Sosenko has put off indefinitely any major expenditures, including having the house repainted. But while his colleagues and even his wife have considered moving across Illinois' eastern border to Indiana, where malpractice premiums are lower, Sosenko can't imagine cutting his ties to his hometown. Not only would he have to take his kids away from their school and friends, but he would have to relocate his wife's elderly parents, whom he and his wife recently moved to Joliet. "I don't want to leave here. I'm too old to start from scratch," Sosenko says.