The state agency charged with protecting patients in Illinois says it plans to lay off most of its medical regulators next week, a move officials say will drastically affect their ability to license and discipline physicians.
The Illinois Department of Financial and Professional Regulation, which has come under fire in the past for not doing enough to protect patients from bad doctors, said that on Tuesday it will eliminate 18 of 26 positions in its medical unit, cutbacks that officials are blaming on a $9.6 million shortfall.
Some doctors, hospitals and patient advocates reacted with alarm to the announcement, issued in a letter posted Wednesday on the department's website. National consumer advocate Dr. Sidney Wolfe said the job eliminations were akin to a city announcing that it no longer could afford police officers and therefore was disbanding the force.
"They are greatly reducing their ability to investigate and properly police doctors," said Wolfe, director of Public Citizen's Health Research Group, a consumer and health advocacy organization. "This is a major threat to the health and safety of people in Illinois."
Some hospital officials said the licensing delays could cause major staffing and training problems as early as this spring at academic medical centers and other hospitals that employ medical residents.
"The inability to secure medical licenses for our residents and fellows in a timely fashion from the IDFPR will have a significant negative impact on our training programs and on patient care at the hospitals in which our residents and fellows train," said Dr. Joshua Goldstein, associate dean for graduate medical education at Northwestern University's Feinberg School of Medicine. "This is true not only for Northwestern and its affiliates but for every hospital in the state of Illinois that trains residents and fellows."
Last year, processing 2,325 temporary licenses for medical residents required the agency to hire temporary staff to assist four full-time licensing specialists, Hofer said. This year, with one full-time specialist and no money for temps, "we're anticipating a significant backlog," she said.
Physicians already practicing could experience delays of up to 18 months to renew a license, meaning the licenses almost certainly will expire before a renewal can be processed, according to the agency. It is illegal to provide medical services in the state without a valid license.
The three-year licenses of about 46,000 Illinois doctors expire in July 2014. New doctors and those who move to Illinois will be affected sooner.
Hofer also said the staffing cuts "will slow down our ability to investigate complaints against doctors who have done something problematic and slow down our ability to prosecute cases."
The agency's medical unit is funded by physicians' licensing fees, which have remained the same since 1987 at $300 for three years. The unit now spends about $1.8 million more than it collects in licensing fees paid by physicians, according to the letter posted this week.
The agency has been criticized in the past for not moving swiftly to discipline doctors. A Tribune investigation in 2010 uncovered 16 sex offenders who held state medical licenses, none of whom had his license permanently revoked after his conviction.
New laws require that regulators permanently revoke the medical licenses of Illinois health care workers convicted of certain crimes, as well as create a chaperon system for any doctor charged with a crime that would place him on the sex offender registry or who allegedly hurt a patient.
To run that program, "we need people to reach out to the doctor, review the order, make sure the people on the list know they are a chaperon, check that (the chaperon) is in good standing and make sure the order is being enforced. It's another responsibility placed on us by the General Assembly that requires manpower," Hofer said.
Last year the agency was required to add a full-time position to create and maintain physician profiles on its website so consumers can check the backgrounds of doctors, including whether they have had any judgments, settlements or convictions in Illinois.
In their letter, agency officials complained that the Illinois State Medical Society had not supported a failed push in the state Legislature for an infusion of $9.6 million to prevent the personnel cuts. The money would have been borrowed against doctors' fees to be collected in 2014.
Dr. William Werner, president of the physicians group, said the funding for the agency was depleted because previous Legislatures had transferred almost $9 million to other programs that had nothing to do with medical licensing and discipline.
"Our point is, restore those funds that have been taken out rather than asking the doctors to build the fund back up again," he said.
The proposal, Werner said, would have resulted in a steep medical license fee increase in 2014 — pushing the cost to $750 — to pay back borrowed money and support the future operational needs of the licensing and discipline unit.
"We're being portrayed as the villains in this whole situation when it really has to do with what happened with prior General Assemblies," Werner said. "This should not all be put on the backs of doctors."
Hofer said Illinois' licensing fees for physicians are relatively low at $100 a year, citing as examples $404 in Texas and $150 in Kentucky.
Dr. Susan Vanderberg-Dent, associate dean for graduate medical education at Rush University Medical Center, expressed concern that some medical students will not apply for positions in Illinois because they won't be able to get licensed in time.
"For them to be hired here as a resident, they must have a license," she said. "We can't hire them, pay them or give them benefits if they aren't employed, and to be employed, they must be licensed."
Lengthy delays in licensing could be disastrous for hospitals as well, she said.
"Residents are an integral part of the care of patients in the hospital … so if there are 200 fewer residents (at Rush), that would be a huge problem in taking care of our patients, given the volume we have," Vanderberg-Dent said.
Most incoming residents graduating from medical school get matched to their future residency programs in March, Goldstein said. They have about three months — from March until June — to get their medical licenses. If they don't, "the residency programs will be severely short-staffed until they are able to begin their clinical training," Goldstein said.