There are a number of great medical centers in Illinois, and the Chicago area in particular. And, ostensibly there is a lot of opportunity in Illinois for physicians. But, many doctors do not want to go into hospital employed practice. Some physicians look to get into private practice, where they can potentially move into an ownership role and have an impact on the business side of medicine.
While many hospitals will pay for continuing or tail coverage after a physician leaves employment, most private practices specifically place the responsibility for such coverage on the individual physician. For some practice areas, the expense for tail coverage can be staggering in Illinois. At the same time, just over the border in Indiana (not to mention other further states), malpractice coverage costs are significantly lower.
Physicians in Illinois who read their private practice employment agreements carefully may be able to negotiate tail coverage provisions, but many doctors focus primarily on the terms addressing compensation and non-competition. Some physicians are completely unaware of the potential long term costs of their employment arrangement.
The effect of high tail coverage costs has led many physicians with ties to Illinois to seek out of state employment. We are especially seeing this in high cost specialties such as obstetrics. And, it does not appear that effective insurance reform can be expected anytime soon. Because of this, it is crucial that doctors review and negotiate terms of tail coverage before accepting employment.
A physician who properly negotiates his/her contract before accepting employment, can often minimize the financial exposure of a move down the line. It's disheartening to know that you will have to pay large amounts of money to ever change employers, but it's just plain naive not to address the issue before starting employment.
