Welcome to the next edition of ArMA's Liability Review. Through this publication, we will keep you updated on the growing medical liability crisis and the reform activities being pursued by ArMA. In this edition, you will find an article on arbitration - an option being explored by ArMA as one way to bring relief to physicians.

We've also included another edition of Rumor Control, where we attempt to separate fact from fictionwe're, weíre including a brief overview of the Oct. 21 Rally for Medical Liability Reform - withrmówith a link to much more information!

We hope you find this publication helpful and informative. If you have any questions, suggestions or comments, please email asmiley@azmedassn.org. Thanks!

More than 2,400 people from virtually every Arizona community banded together at a rally on the evening of Oct. 21 in support of medical liability reform. Bearing red wristbands, doctors left determined to carry forward the message of the need for change and the potential this issue has tpatients'patientsí access to care. The Arizona Medical Association and the Maricopa County Medical Society cosponsored the rally.

The time to act is now before even more Arizona patients have trouble finding the necessary health care, said Philip Keen, MD, president of the Arizona Medical Association, who addressed the crowd at Phoenix Civic Plaza. There are already some Arizona communities, and some medical specialties, which are at the crisis point. Patients are already running into problems accessing health care in this state. We need to work together to resolve this and to make sure the situation improves.

Bryan Updegraff, MD, president of the Maricopa County Medical Society also spoke at the rally, issuing a warning about what the future could hold for Arizona if nothing is done. Our litigation system is threatening our medical system. If isn't something isnít done soon, more physicians will leave the profession of medicine, just as Arizonian's Arizonaís population grows exponentially leaving fewer to care for our citizens. This issue is not unique to health care. This has become a highly litigious society where, unfortunately, people are looking for deep pockets in the education system, municipalities, corporations and the like. This affects us all by increasing costs for many of the things we hold most dear...our health, our children's childrenís education and our communities.

In response to a rapidly growing access to care problem, and physician concerns with double digit increases in medical liability insurance premiums, the Arizona Medical Association (ArMA) Board of Directors authorized the creation of Arizonans for Access to Health Care (AAHC) to serve as the action agency for directing and funding a physician attack on the problems created by the existing medical liability environment.

AAHC will be initially governed by a board of directors composed of the ArMA Executive Committee, although it is anticipated this structure will be altered to accommodate new partners in the decision-making process. AAHC's

The AAHC's agenda will include action items such as rallying physicians, media presentations and adstate'swith the state's elected leadership. It will also contain strategic elements, which may include public opinion research, focus groups, polling and the testing of voter initiative or referendum to change ouAAHC'stitution. AAHC's goal is to work aggressively, but intelligently, to craft immediate and long-term solutions to medical liability insurance concerns, and then tactically marshal the resources and energy necessary to implement agreed to programs and legislation, including research to develop and test language for a ballot measure.

Additionally, AAHC will sponsor physician and health care institution mobilization and build advocacy networks to secure legislation and effective programs. It will also help implement a focused media effort that will work to get our message to the public to shape public opinion about the decreasing availability of physician services, on a factual basis.

In order to achieve the above, we need funding-and fundingóand lots of it. We are asking every physician to donate $500, or as much as he or she can, to support AAHC. Your contribution is 100% deductiblexpense-AAHCess expense-AAHC is paying the proxy tax for 2004, so you may deduct the ENTIRE amount of your donation.

To make a contribution, please send your check made out to Arizonans for Access to Health Care, and mail to 810 W. Bethany Home Road, Phoenix, AZ 85013. Questions? Call Cathy Schmit at 602-347-6913 or email at cathyschmit@azmedassn.org.

In this section of the Liability Review, we will take a look at ideas, stories, etc. that are circulating in the Arizona physician community, or the community at large, and attempt to put some fact to the apparent fiction.

1. Are doctors really having trouble getting insurance? Yes, in certain specialties and in certain areas of our stateóbut the problem is growing. An April 2004 survey conducted by Tucson Medical Center (TMC) found that 20 of 29 ob-gyn respondents reported having difficulty affording or obtaining medical liability insurance. Additionally, 45 percent of all physician respondents to the TMC survey reported having trouble affording medical liability insurance. In terms of raw premiums, rates were actually higher in the late 1980s, but reimbursements for care were also higher. On a relative basis, this may well be as bad as it has ever been.

2. Is it true weíve had this problem before? Yes. The problem of availability and affordability of medical liability insurance is not a new one. In the mid-80s and 90s, medicine faced similar problems and attempted three times, in 1986, 1990 and 1994, to amend the constitution via initiative; each attempt failed. What is compounding the problem today is a shortage of physicians, identified recently by both the Goldwater Institute and St. Lukeís Health Initiatives.

3. What happened to periodic payments for damages? In 1994, the Arizona Court of Appeals ruled unconstitutional the stateís periodic payments law, which had required payment of damages over time, instead of via a one-time, lump-sum payment.

4. How does the public feel about the medical liability situation? A recent Blue Cross Blue Shield of Arizona (BCBS) study reveals they are concerned.

• 83% agree that medical malpractice lawsuits affect the cost of health care.
• 70% agree that this could affect access to health care.
• 78% agree that change is needed, with more than half believing in major change.
• 77% favor limiting the amount of judgments awarded for pain and suffering.

To view the BCBS study, click here

The arbitration alternative to medical negligence litigation

By Barry D. Halpern

Physicians are increasingly convinced that the medical malpractice litigation system is seriously flawed. Although proponents of the systemóprincipally plaintiff personal injury lawyersótout the need to compensate "victims" and police the health care profession, there is little evidence that the current system does either of those things effectively.

To read the full article, please click here.