The spiraling cost of medical malpractice insurance is putting doctors out of business, they say. Eventually, they warn, patients could have a hard time finding specialists.

Hundreds of doctors clad in white coats descended Wednesday on the Missouri Legislature to lobby for changes they say will lower their medical malpractice rates.

More than 750 doctors cornered senators and representatives to tell them that malpractice insurance rates are rising -- in some cases more than tripling in the last year alone. The costs are driving some doctors out of business.

Malpractice rates for obstetrician/gynecologists range from $60,000 to $120,000 a year, said Dr. James Schreiber, the chairman of the obstetrics and gynecology department at Washington University School of Medicine and at Barnes-Jewish Hospital.

The expense is forcing some experienced doctors into early retirement and leading some newer doctors to quit practicing, he said.

Doctors must begin paying malpractice premiums long before they''ve built up their practices. If malpractice insurance rates keep rising, Schreiber said, it will become more difficult for patients to find specialists.

"I''m really worried for my patients," Schreiber said. "It''s a tragedy for them and a tragedy for society."

The so-called White Coat Day came on the heels of the State of the Union speech by President George W. Bush on Tuesday night. Bush said he wanted to pass tort reform legislation to rein in the cost of malpractice insurance.

It''s a national problem. Doctors in some cities have staged walkouts to draw attention to the issue. In Illinois, doctors would like to see tort reform, but any such effort would face a huge uphill battle in the Democrat-controlled Legislature.

Physicians are pressing the issue this year in Jefferson City in no small part because Republicans now control the Missouri House and Senate. GOP leaders in both chambers have come out in favor of two tort reform bills, which they say will help cure what ails the medical profession.

Democrats, who get a lot of money from the Missouri Association of Trial Attorneys, generally say tort reform may not be the answer. At a House Judiciary Committee hearing on the issue, Rep. Rick Johnson, D-High Ridge, said reforms should also focus on how insurance companies set rates.

"If we only focus on tort reform, you''ll be here in two years" complaining about malpractice rates, Johnson said. "We need to focus on more than one possible solution."

Generally, doctors want laws that would curb "frivolous" lawsuits by forcing those who lose malpractice cases to pay attorney fees. They want better caps on "pain and suffering" awards and limits on where cases can be tried.

At Wednesday''s hearing, Rep. Connie Johnson, D-St. Louis, asked a gynecological oncologist how many doctors from the St. Louis Metropolitan Medical Society volunteer at poverty care programs and how many practice in the city of St. Louis.

The oncologist, Dr. Al Elbendary of Kirkwood, said doctors "avoid going to the city because of the tort issue." St. Louis juries have the reputation of giving generous awards in medical malpractice cases.

"The city of St. Louis, like it or not, is considered a high-risk environment," Elbendary said.

The doctor''s rounds were carefully choreographed. After a rally in the Capitol rotunda, physicians spread out, covering almost every corner of the building.

And sometimes, they had to wait.

The Senate Judiciary, Civil and Criminal Jurisprudence Committee was supposed to have an informal meeting on malpractice issues starting at 10:30 a.m. But Senate debate on the state''s budget problems ran longer than expected. The hearing didn''t begin until after noon.

Doctors targeted key lawmakers like Sen. Ken Jacob, D-Columbia, a lawyer who has questioned whether tort reforms would help doctors. Citing a report by the Missouri Hospital Association, Jacob said Missouri has not seen an increase in the volume of malpractice claims. The report also says that rates are up because insurance companies have invested in bonds, and interest rates on bonds are low.

More than a dozen physicians also met with the director of the state Department of Insurance, Scott Lakin, a former lawmaker. Lakin said that he had been studying rising rates for months and that he would submit a report on the issue to Gov. Bob Holden on Monday.

The governor is expected to announce his ideas for malpractice reforms next week.

Holden did not meet with the doctors Wednesday because he was out of the state. His spokeswoman, Mary Still, said Holden recognized that doctors were "paying pretty high premiums" and that he wanted to pass legislation that would really solve the problem.