SOUTHERN ILLINOIS - Local doctors have high hopes for what President George W. Bush will say Wednesday when he addresses medical malpractice tort reform during a speech in Collinsville, but some citizens and lawyers contend the visit won't hit the root of the problem.

Bush is scheduled to appear Wednesday afternoon at the Gateway Center in a town hall meeting, with an audience of roughly 1,500 people, most of whom are physicians from across the state. The president's visit to Madison County comes shortly after a vicious state supreme court race between Democrat Gordon Maag and Republican Lloyd Karmeier - largely because of the medical malpractice issue - and after the area has been reaffirmed as the nation's number one "judicial hellhole" by the American Tort Reform Association.

Physicians have been fighting a battle within the Illinois legislature for nearly a year, pressing lawmakers to enact some form of relief from skyrocketing medical liability premiums, which they say are forcing doctors to quit the business.

The Metro East area has seen the largest exodus of physicians in the past year, nearing 200 professionals, but Southern Illinois has also seen its share of problems from the issue, including losing its only two neurosurgeons.

To date, the Illinois general assembly has yet to pass any legislation that addresses medical malpractice, although several bills have been proposed and Gov. Rod Blagojevich has appointed a special mediator to continue negotiations between interested parties.

Carbondale physician Michael Delaney said Madison County definitely epitomizes the medical malpractice crisis, and he is glad to see nearly a year's worth of discussion on the issue is drawing some national attention.

"I'm very excited to see him (Bush) in an area that is particularly affected by the issue," Delaney said. "This is not a bunch of people whining; this is a series of events that have had serious ramifications, being it has nearly decimated an entire sect of professionals - the medical community."

Delaney said if he can make it to Collinsville for Wednesday's event, he is going. He hopes, if nothing else, Bush's address amplifies the debate on medical malpractice to a level that can't be ignored by state leaders in Springfield in the upcoming legislative session.

"I personally don't see how they can ignore it, but I ceased being surprised about the politician's reality," he said.

Medical malpractice is an obvious focus for many local lawmakers in the spring, so Delaney said he believes the issue will be discussed, especially with the national attention that is being drawn.

Marsha Ryan, a Carbondale general surgeon who has been vocal about the need for a solution to rising insurance costs for doctors, said the president's visit may mark a milestone in physicians' struggles.

"I'm thrilled (Bush) has put the spotlight on this issue," Ryan, who will attend Wednesday visit, said. "For us this is just huge. We have been laboring in obscurity; as you know, we haven't had much success at the state level.

"Any opportunity to meet a president is amazing, but particularly when it has such an impact on your profession," she added.

The president's visit doesn't strike the right chord for everyone, though. The Center for Justice and Democracy-Illinois, a judicial watchdog group that doesn't favor tort reform, plans to request a meeting with Bush for survivors of legitimate medical malpractice cases to speak. The group fears Bush may press a plan that takes away a patients' rights in the courtroom. Group members plan to speak today in the Collinsville Holiday Inn, located next to the Gateway Center.

Illinois Trial Lawyers Association President Kevin Conway, of Chicago, said it doesn't appear the president has any plans to listen to either citizens or attorneys during his visit.

"I think what they are trying to do is stage a media event for legislation harmful to the public's rights," Conway said.

He said no member of the association has been invited to attend Wednesday's function. In fact, Conway added, he doesn't believe any trial lawyer has been invited to the visit.

"I'm fairly certain there is not going to be a fair discussion as to the problems of medical malpractice," he said.

Conway said it's obvious there is some crisis affecting doctors' insurance premiums. However, he said, statistics show medical negligence cases filed in recent years have decreased, the Illinois Department of Professional Regulation shows there are 9,000 more doctors in Illinois than 10 years ago, and the Illinois Department of Insurance shows payouts on insurance claims have been relatively flat for the Illinois State Medical Insurance Exchange, which represents 56 percent of doctors in the state.

Conway also said in 2003 the insurance department reported ISMIE took in $176 million more than it paid out, and in 2002 the organization quoted "investment losses" as the reason it was increasing rates.

"We think doctors are being gouged, and if they've been gouged that needs to be fixed," Conway said. "I don't think the president is going to get into that, I think he's going to blame trial lawyers, then the citizens."

-Andrea Hahn contributed to this report.

caleb.hale@thesouthern.com 618-529-5454 x15090