LUCY SCHULTZE

Winston Capel, MD, moved his practice from Mississippi at the height of the state's tort-reform struggle — a "drastic" move, he admits, but the only thing he thought would get lawmakers' attention.

Five years later, when the tide had turned, the opportunity to return was much more than a business decision. It was a homecoming.

"I missed the camaraderie I had with the Mississippi physicians — many of whom I had worked with during my training, and with whom I shared a common history and esprit de corps," said Capel, who joined Central Mississippi Medical Center in solo practice in August.

As one of only two board-certified, fellowship-trained spinal neurosurgeons in the state, his rare specialty is a valuable one. So much so, in fact, that more than 30 surgical patients followed him from Mississippi to Oklahoma, where he practiced at St. Anthony Hospital in Oklahoma City. More than 50 traveled to meet with him there for follow-up care.

"It was painful," he said of the uprooting experience. But the issue of crippling malpractice insurance premiums was painful, too — both for physicians and, ultimately, for the patients they served.

"We as physicians really felt like the state Legislature and the governor just weren't understanding how important the issue of tort reform really was," Capel said.

"I really felt like I needed to communicate that this was a public-health crisis and that if it wasn't fixed, we would lose physicians."

To get that message across, Capel took out a full-page newspaper advertisement announcing his departure from the state and blaming the malpractice crisis.

While the public notice garnered no direct response from state legislators, it earned him a chance to further make his case in a television interview with Jackson's WLBT-Channel 3.

His plan to leave also drew a swift response from his referring physicians.

"They were mad that we had to leave," he said. "But they also realized that there had to be some pain if we were going to achieve this change."

Capel spent two years practicing in Oklahoma, followed by another two years in his home state of Utah, at Lakeview Hospital in the Salt Lake City area. A couple of patients from Mississippi even traveled that distance to see him for surgery.

Utah itself was home in certain ways — from his family ties to the outdoor pursuits Capel had enjoyed while going up there. But its medical community was not.

"There were more managed-care issues to deal with there," he said. "And we missed being in Mississippi."

Meanwhile, Capel watched from a distance as the effects of the 2004 Tort Reform Act, championed by Gov. Haley Barbour, began to stabilize the medical-malpractice horizon in Mississippi.

Insurance companies began returning to the state and easing their restrictions, while the several Mississippi jurisdictions previously labeled "judicial hellholes" by the American Tort Reform Association were now praised as model turnaround stories in that group's annual rankings.

For Capel, the key indicator of the new law's success was measured objectively — in falling rates for malpractice insurance.

"I was watching the malpractice premiums continue to drop," he said. "That trend really reflects the number of claims, and with tort reform, there was this dramatic reduction in the frequency of claims — resulting in reduced premiums."

Since he returned to Mississippi, the premiums paid by Capel's practice today are 15 to 20 percent less than what they were five years ago, he said.

"We are small businesses," he said. "And for a neurosurgeon, malpractice insurance is the number one cost of doing business."

A graduate of The Chicago Medical School, Capel initially came to Mississippi to train under the late Dr. Robert Smith. Smith, the chair of UMC's Department of Neurosurgery from 1979-94, was the author of the textbook "Essentials of Neurosurgery," and directed the gamma knife center at CMMC which now bears his name.

Capel completed his internship and residency at UMC, followed by a spine fellowship at the University of Maryland in Baltimore. After his fellowship, he returned to Jackson to join Smith in private practice until his mentor's death in 2003.

At UMC, Capel was named Teaching Resident of the Year for 1996-97 in the Alpha Omega Alpha Honor Society chapter. He served as clinical assistant professor of neurosurgery at UMC from 1998-2004.

Capel is a member of the American Medical Society, the Congress of Neurological Surgeons and the North American Spine Society, and is a Fellow of the American College of Surgeons.

His practice is now located in the Medical Office Building on CMMC's campus in southwest Jackson.

Outside of work, his favorite pursuits include water skiing and snow skiing, as well as spending time with his family. He and his wife, Noelani, have three children: Casie, 10, Isaac, 7, and Seth, 4.