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Pima County Medical Society

Home Medical Society of the 17th United States Surgeon-General

M AY 2 0 1 6

Far West Ajo provides variety

in the Sonoran Desert
Dr. Cairns appointed
Dean of UA College of Medicine
The new Tucson Concussion Center
moves in

Dr. Fagan catches up on the Arizona Legislature

PCMS Celebrates Five Years with WWAD Program


Pima County Medical
Society Officers

Official Publication of the Pima County Medical Society

Jerry Hutchinson, DO
Roy Loewenstein, MD
Kevin Moynahan, MD
Snehal Patel, DO
Wayne Peate, MD
Kenneth Sandock, MD
Sarah Sullivan, DO
Salvatore Tirrito, MD
Debra Townsend, MD
Fred Van Hook, MD
Scott Weiss, MD
Leslie Willingham, MD
Jaren Trost, MD (Resident)
Aditya Paliwal, MD (alt. resident)
Jared Brock (student)

Timothy C. Fagan, MD
Michael A. Dean, MD
Susan J. Kalota, MD
Unfilled / Appointment
Melissa D. Levine, MD

PCMS Board of Directors

David Burgess, MD
Howard Eisenberg, MD
Kelly Ann Favre, MD

Members at Large

At Large ArMA Board

Charles Krone, MD
Clifford Martin, MD

Robert M. Aaronson, MD
R. Screven Farmer, MD

Board of Mediation

Pima Directors to ArMA

Timothy C. Fagan, MD

Thomas Griffin, MD
Evan Kligman, MD
George Makol, MD
Sheldon Marks, MD
Mark Mecikalski, MD

Delegates to AMA
Timothy C. Fagan, MD (alternate)
Gary R. Figge, MD
Michael F. Hamant, MD (alternate)
Thomas H. Hicks, MD

Arizona Medical
Association Officers
Michael F. Hamant, MD
Vice President
Thomas C. Rothe, MD
Outgoing Past President

Executive Director
Bill Fearneyhough
Phone: (520) 795-7985
(520) 323-9559
E-mail: billf

Bill Fearneyhough
I welcome your feedback and story ideas.
E-mail: billf

West Press
Phone: (520) 624-4939

Dennis Carey
Phone: (520) 795-7985
(520) 323-9559

Art Director
Alene Randklev
Phone: (520) 624-4939
(520) 624-2715

Pima County Medical Society
5199 E. Farness Dr., Suite 151
Tucson, AZ 85712
Phone: (520) 795-7985
Fax: (520) 323-9559


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Vol. 49 No. 5

SOMBRERO (ISSN 0279-909X) is published monthly

except bimonthly June/July and August/September by the
Pima County Medical Society, 5199 E. Farness, Tucson,
Ariz. 85712. Annual subscription price is $30. Periodicals
paid at Tucson, AZ. POSTMASTER: Send address changes
to Pima County Medical Society, 5199 E. Farness Drive,
Ste. 151, Tucson, Arizona 85712-2134. Opinions expressed
are those of the individuals and do not necessarily represent
the opinions or policies of the publisher or the PCMS Board
of Directors, Executive Officers or the members at large,
nor does any product or service advertised carry the
endorsement of the society unless expressly stated. Paid
advertisements are accepted subject to the approval of the
Board of Directors, which retains the right to reject any
advertising submitted. Copyright 2016, Pima County
Medical Society. All rights reserved. Reproduction in whole
or in part without permission is prohibited.


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5 Dr. Timothy C. Fagan: An Update on the Arizona
Legislature Regarding Medical Issues
8 UA College of Medicine: Dr. Charles B. Cairns
Appointed Dean of UA College of Medcine Tucson.
9 BUMC News: Dr. Paul Gee and Dr. Ana Sanguineti on
Staff of New Geriatric Consultation Clinic at Banner
University Medical Center.
10 Grand Opening: The New Tucson Concussion Center
Opens Its Doors at 5199 East Farness Road.
12 Road Trip: Far West Ajo is an Easy Accessible GetAway that Combines the Beauty, History and
Adventure of the Sonoran Desert.
15 Makols Call: Hunger Pains are Not A Problem in
Todays Doctors Office.
16 In Memoriam: Remembering Dr. Brendan Phibbs.
18 Walk With A Doc: PCMS Members Help Patients Get
Moving In National Program.
20 Navajo Scholarships: UA College of Medicine Signs
Agreement to Establish Scholarship Fund to Help
Navajo Medical Students.
22 Educational Programs: Upcoming CME and medical
information events.

On the Cover
A jackrabbit uses its speed to avoid capture in the desert, but this
one was caught at a slow shutter speed at dusk which makes for
an interesting image. (Dr. Hal Tretbar photo)


Another Busy Year for Organized Medicine

By Dr. Timothy C. Fagan
PCMS President

t has been a particularly crazy

year at the Arizona legislature.
More than 1,250 bills were
introduced, approximately 120
of which were directly medical
or with medical implications.
These bills were monitored by
Arizona Medical Association,
Arizona Osteopathic Medical
Association, Arizona Chapter of
the American College of
Physicians, Pima and Maricopa
Medical Societies and other
Arizona medical organizations.
Hundreds of hours were
dedicated to monitoring legislative activities.
As of this writing, the Legislature is still in session but Governor
Ducey has asked that no additional bills be sent to him until the
state budget is finalized. As a result, a number of bills included in
this article have yet to see final action.
SB1473/APRN Scope of Practice: The primary focus of organized
medicine this session was SB1473 which proposed at least five
separate changes in Arizona law, affecting four categories of
Advanced Practice Registered Nurses (APRNs) and assigned many
responsibilities to the State Board of Nursing. The overall goal
was to remove all physician oversight of and collaboration with
APRNS from Arizona Statute and at the same time change RN
licensing guidelines.
The more controversial issues were (1) expanded powers of the
BON (2) prescribing authority for Clinical Nurse Specialists (3)
removal of presence and supervision requirements for Certified
Registered Nurse Anesthetists (CRNAs) (4) prescribing authority
for CRNAs (5) allow CRNAs to provide independent pain
management services.

practice (Residency) between physicians and APRNs. ArMA and

representatives from other medical societies testified against the
bill at the Committee of Reference on the APRN sunrise
application in December of last year, and at multiple Legislative
hearings and stakeholder meetings.
The bill also demonstrated a complete lack of understanding of
DEA Schedules of controlled substances based upon abuse
potential, as well as a lack of understanding of what constitutes
basic and/or advanced Pharmacology instruction. Thankfully,
S1473, died in the legislature but the collaboration provision
was revived under striker bill H2236. The bill was not opposed
by organized medicine, but the Arizona Nurses Association
decided that the timing was not right, and H2236 also died.
Organized medicine continues to vigorously support the
contributions of APRNS, as part of a physician-led team.
HB2309/KidsCare: Arizona is the only state that does not have
the federally subsidized Childrens Health Insurance Program
(CHIP). In Arizona it is known as KidsCare.
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Under the measure, a registered nurse, certified as an APRN, could

be licensed as a Nurse Practitioner. This would be equivalent to
licensing a physician as an Internist rather than an MD or DO
certified in Internal Medicine. At the same time, it would mandate
untold amounts of extra work for the Board of Nursing (BON),
including initially and periodically evaluating all APRN training
programs in the country rather than accepting certification of
these training programs by other entities. This is a task for which
the BON has neither the expertise nor funding to fulfill.
The relatively noncontroversial issues were clarification of
statutory language regarding Nurse Practitioners and Certified
Nurse Midwives to replace collaboration with a physician with
consultation and referral, which reflects current Arizona law.
The proposed legislative changes caused real concern for patient
safety, due to the marked disparity in education and supervised

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insurance. It has been proven that health is worse and expensive

emergency care and hospitalizations are more frequent for those
without health insurance. Since all other states have federally
funded CHIP, Arizonans find themselves financing other state
programs but not their own. B2309 also contained a provision,
that in the event the feds withdrew funding, the program could
be cancelled with a 30 day notice.
The bill passed the House, but State Senate President Andy Biggs
refused to assign it to a Committee in the Senate, where it could
be discussed and receive a vote. Failure to consider HB2309 in
the Senate relegated 30,000 Arizona children to poorer health
and suffering, while increasing costs to state taxpayers. Our hope
is that the program can be reinstituted by including it in the
H2502/Medical Licensure Compact: The bill would establish a
medical licensure compact to allow physicians to become
licensed in multiple states. It would adopt the prevailing standard
for licensure and require the physician to be under the
jurisdiction of the state medical board where the patient is
located. It would establish license eligibility and application
requirements. It would establish an Interstate Medical Licensure
Compact Commission and establish Commission powers and
duties. It would provide conditions for withdrawal from and
dissolution of the Compact. The bill easily passed the House. It
was heard in the Senate Health and Human Services Committee
in March. It passed 4-3, and then was approved by the Senate
Rules Committee. It awaits final action in the Senate.
SB1283/CSPMP: This bill requires physicians to check the
Controlled Substances Prescription Monitoring Program (CSPMP)
before prescribing opioids and benzodiazepines. Specifying only
opioid and benzodiazepines displays complete ignorance of the
DEA Drug Schedules, which classify drugs according to abuse
potential. Including only one class of drugs, some of which are in
Schedule II, some in Schedule III as well as one class from
Schedule IV, leaves out many drugs with high abuse potential. It
was also unclear when a prescriber was required to check the
database. It received Senate approval after several improving
amendments were adopted. It awaits final House action.
SB1363/Telemedicine; Insurance Coverage: This bill would
require that health and disability insurance policies or contracts
executed or renewed on or afterJanuary 1, 2017provide
coverage for health care services for trauma, burn, cardiology,
infectious diseases, mental health disorders, neurologic diseases
and dermatology that are provided through telemedicine
(defined as the use of interactive audio, video or other electronic
media for diagnosis, consultation or treatment), if the service
would be covered were it provided through in-person
consultation, and if the service is provided to a subscriber
(patient) receiving the service in Arizona. The bill would expand
insurance coverage to all areas of the State, not just rural, and
adds pulmonology services in 2018. The bill does not apply to
limited benefit coverage. The Senate has approved the bill along
with the House Insurance Committee. It awaits final approval
from the House.
H2501/Health Regulatory Boards: The bill is dead for this
session. The measure had called for the Department of Health
Services (DHS) to assume the administrative authority of health
profession regulatory boards in specified fiscal years.

The rationale for this legislation was that it would achieve savings
through consolidation and offer shelter against antitrust lawsuits.
A short time ago, the North Carolina Board of Dental Examiners
lost an antitrust lawsuit when non-dentists claimed the Board,
made up of a majority of dentists, was preventing them from
performing teeth-whitening services.

that 200 mg of mifepristone is appropriate, as is use up to 10

weeks of pregnancy. It is possible that a new bill, reflecting the
new FDA guidance, could be introduced this year. Regardless, this
bill amounts to the Arizona Legislature telling physicians what
they can tell patients and prescribe, even if it is scientifically

SB1112/Pharmacists; Scope of Practice: The bill would allow

licensed pharmacists to administer influenza vaccines to a person
at least three years old, booster doses for the primary adolescent
series as recommended by the U.S. Centers for Disease Control
and Prevention (CDC) and immunizations or vaccines
recommended by the CDC, to a person who is at least 13 years of
age. Previously, a licensed pharmacist could only administer
immunizations, influenza and other vaccines to persons at least
six years of age and in response to a public health emergency. A
pharmacist who administers an immunization or vaccine is
required to report the administration to the persons identified
primary care provider or physicianwithin 48 hours and
establishes efforts pharmacists must undertake to identify the
persons primary care provider or physician. Failure to do so is
considered unprofessional conduct. As opposed to the APRN
scope of practice bill, this was proposed as a Sunrise Application
in 2014 for the 2015 Legislative Session. It met considerable
opposition and did not pass the Committee of Reference (COR).
The sponsors met with all stakeholders, and submitted a new
Sunrise application in 2015, which passed the COR without
opposition. The bill has undergone one minor change and now
awaits final House approval.

Budget: The Governor is proposing a $9.84 billion budget.

Revenues are expected to reach $10.27 billion, resulting in a
projected surplus of $430 million, or 4%. At the recommendation
of the Governor and his health advisors, the bill continues to
block the previously proposed 5% cut in payments to AHCCCS

H2310/Biological Products; Prescription Orders: Under this bill,

a pharmacist is permitted to substitute a biological product for a
prescribed biological product only if a list of specified conditions
is met. Conditions include a determination by the U.S. Food and
Drug Administration that the substituted product to be an
interchangeable biological product (defined), and that the
prescribing physician does not designate that a substitution is
prohibited. The bill has won House approval and now faces a
Senate concurrence vote before heading to the Governor desk.

Legislator Leadership: Arizona Senate Leadership will change

next year. Matt Salmon is retiring as U.S. Representative from CD
5. Andy Biggs is retiring as President of the Arizona Senate to run
for the seat against Maricopa County Supervisor Don Stapley and
Arizona Representative Justin Olson. Steve Yarbrough of Gilbert
will be the new Senate President while Debbie Lesko, an ally of
organized medicine in confronting APRN Scope of Practice bill,
will become President Pro Tem of the Senate and Chairman of the
Senate Appropriations Committee. Kimberly Yee becomes Senate
Majority Leader.
If physicians have the time to track legislative bills and advocate
for or against them, they should do so. In the absence of the time
and will to do so, all physicians should ensure they are members
of their County, State and Specialty Societies. These organizations
are essential and diligently represent and advocate on behalf of
physicians around the state.

SB1324/Mifeprex: The legislation mandates compliance with the

Mifeprex package insert. The FDA-approved guidelines took
effect in December of last year and include the use of a 600 mg of
mifepristone dose, which is three times the previously
recommended amount.
Opposition to SB1324 related solely to ensuring physicians have
the ability to determine appropriate treatment for patients
pursuant to the best scientific, evidence-based medicine.
Representatives met with Sen. Kimberly Yee prior to the
committee hearing to carefully explain opposition to the bill was
not due to an anti-abortion stand but science based, since it
forces physicians to use outdated FDA labeling information when
prescribing medication to induce an abortion. Senator Yee
appreciated knowing that, and explained in turn that her
motivation is merely to correct what a court held to be a fatal
flaw in her previous attempt to legislate in this area. The court
threw out the prior law she sponsored because it required
compliance with FDA protocols but failed to identify a specific
FDA label as the standard to be applied.
The bill was passed by the Legislature, and signed by the
Governor. Almost simultaneously, the FDA issued new guidance

UA College of Medicine

Cairns Appointed Dean at College of Medicine

harles B. Cairns, MD has
been named Dean of the
University of Arizona College of
Medicine after serving more
than a year as interim. It was
effective April 11.

When making the announcement, Senior Vice President for

Health Sciences Dr. Joe Skip
Garcia said As interim dean
for the past 14 months, Dr.
Cairns has provided outstanding
leadership stability and played
a critical role in the transition
of the colleges clinical practice
group under the Universitys
Charles B. Cairns, MD
Academic Affiliation Agreement
with Banner Health. His
leadership skills and passion for academic excellence have been
recognized and embraced by everyone at the college and by our
colleagues within the University and from Banner Health.
The Dartmouth College graduate joined the UA Health Sciences in

November 2014 as assistant vice president for clinical research

and clinical trials, vice dean of the UA College of Medicine
Tucson and professor in the UA Department of Emergency
Medicine. Prior to joining UA, Cairns was professor and chair of
the Department of Emergency Medicine at the University of
North Carolina at Chapel Hill.

Cairns completed an emergency medicine residency and EMF

Research Fellowship at the Harbor-UCLA Medical Center and
post-graduate training in the Program in Genetics of Complex
Diseases at the Jackson Laboratory in Bar Harbor, Maine. He is
board-certified in emergency medicine, a fellow of the American
College of Emergency Physicians and fellow of the American
Heart Association.
His research interests include the host response to acute
infections, illness and injury, trauma, cardiac and pulmonary
resuscitation and systems of emergency and critical care. He
currently serves as director of the U.S. Critical Illness and Injury
Trials Group which is funded by the National Institutes of Health
and the U.S. Department of Health Services.
Cairns is a member of the Pima County Medical Society and as
dean serves on its board of directors.

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BUMC Opens Geriatric Consultation Clinic

anner University
Medicine recently
announced the April 1
opening of their new
Geriatric Consultation
The new clinic is located
in the Department of
Medicines Multispecialty
Outpatient Adult
Medicine Department,
1501 N. Campbell Ave.
According to clinic
physician Dr. Paul Gee,
services will include

Dr. Paul Gee

consultations in the diagnosis and management of geriatric

syndromes and conditions such as dementia, frailty, weight
loss, depression, insomnia, multimorbidity, polypharmacy
and falls for complex patients 70 years of age or older.
The goal is to provide patients with the highest value care
possible in support of the patients primary care provider.
Referring physicians will promptly receive a consultation
letter and phone call if necessary, Gee said.
Banner University Medicine Physicians may refer using the
Epic system under Ambulatory Geriatrics. All physician
consultation requests must include the patients name,
date of birth, their contact information and the reason for
the referral. Physicians outside Banner may refer by faxing
the information to 874-7009. Consults are available on
Wednesday and Thursday mornings. n


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Medical Society



Grand Opening

Comprehensive Concussion Center Opens

By Bill Fearneyhough

The center is located in the Tucson Medical Park complex.

The newly remodeled building is now the home of TCC and PCMS administrative offices.

he Tucson Concussion Center (TCC) officially opened its

doors March 29th during a two-hour celebration and ribboncutting ceremony. The new four-thousand-square-foot leased
facility is located in what was formerly the Pima County Medical
Society (PCMS) headquarters. It is the first comprehensive
interprofessional concussion care center under one roof.
The five-thousand-square-foot building was sold to TMC
Holdings, Inc. in September of last year by PCMS, who has leased
the remaining thousand square feet for its administrative offices.
The final touches to the remodeling project were completed midMarch.
According to TCCs Managing Member Dr. Hirsh Handmaker, the
center is unique in that it will offer best practices assessments
and treatment for a multitude of difficulties stemming from a
concussion, from physical challenges like vision or balance issues
to the patients mental health and cognitive ability. The facility
boasts a high-tech physical therapy gym, a 40-meter artificial turf
track, and cutting edge technology. The center will serve patients
six years old and older with traumatic brain injury or with a
history of concussion.
We are already receiving referrals from southern Arizona
concussion specialists, physicians, emergency rooms, and
hospitals, as well as self-referrals generated through general and
social media coverage, he stated.
CDC reports an estimated 1.6 to 3.8 million recreation-related
concussions occur in the United States each year. The vast
majority of those occur among children, adolescents and teens
five-18 years of age. A concussion is a traumatic brain injury that

alters the way the brain functions. Effects are usually temporary
but can include headaches and problems with concentration,
memory, balance, vision and coordination.
It was in 2005 that a little-known, 42-year-old, Nigerian-born
forensic pathologist and neuropathologist discovered and
published findings of chronic traumatic encephalopathy (CTE) by
examining American football players. His findings created an
investigative frenzy among media and put the National Football
League on defense. The league has now taken steps to increase
surveillance measures, including the placement of an
independent neurologist on the sideline for every game.
Long-time PCMS member Michael Hamant, MD, a family practice
and sports medicine physician, will serve as the centers medical
director. He will collaborate with the centers AT Navigator, Carisa
Raucci, PhD, in conducting baseline testing and supervise returnto-play protocols and testing for athletes while overseeing the
facilities integrated treatment team which includes a neurooptometrist, neuropsychologist, audiologist, vestibular and
physical therapists.
Its not the first concussion that is the biggest risk and danger.
Its the second concussion before the brain heals from the first
that is the greater risk, Hamant said.
Not every patient will need to see all members of the team, but
all will be involved in each evaluation, he explained. Once the
comprehensive workup is completed, patients receive an
individualized treatment plan.
Handmaker said close affiliations with local hospitals, physicians,

This is the second such facility Handmaker and his colleagues

have had a hand in creating. The Banner Concussion Center in
Phoenix, the first of its kind in the U.S., was established in 2014.
TCC and the Phoenix facility were conceptualized and developed
by the CACTIS Foundation, a Scottsdale-based institution focused
on advancing the diagnosis, treatment, and prevention of
disease. CACTIS would later form Conquering Concussions, LLC
which manages TCC.
Operating hours are M-F, 8 a.m. to 5 p.m. More information
about TCC is available by contacting the center at
(520) 620-9200 or by visiting the centers website at

Dr. Carissa Raucci prepares the Computerized Dynamic

Posturography unit for patient testing. The machine is used to
quantify the central nervous system adaptive mechanisms
(sensory, motor and central) which control posture and

specialty clinics and other public and private organizations

concerned with concussions have already been established
including the Pima County Junior Soccer League (PCJSL), FC
Tucson and the Pima County Health Department. The center is
providing free base-line testing for PCJSL athletes through a grant
from the TMC Foundation.
The typical soccer mom doesnt have time to make four trips to
four different locations for the young athlete with a concussion.
All the medical records are recorded in an advanced electronic
health record system, in one place, he said. At TCC youll have
the best, most capable professionals all practicing in the same
location collaborating closely on behalf of the patient.

Tucson Concussion Center
5199 E. Farness Drive, Ste. 101
Tucson, AZ 85712
Phone: 520-520-9200
Pima County Medical Society
5199 E. Farness Drive, Ste. 151
Tucson, AZ 85712
Phone: 520-795-7985
Fax: 520-323-9559



Road Trip

Far West Ajo Adventure

Explore the Tohono Oodham Nation, a national monument and our regions copper
mining history during this absorbing Sonoran Desert getaway.
By Monica Surfaro Spigelman
Photos by Leigh Spigelman

bout 150 miles west of Tucson,

the desert calls to you for a
different kind of escape. Heres a
route that takes you westward
through rugged wilderness and
discoveries that include a Native
American cultural center, an historic
mining town with beautiful
architecture, good eats and arts
and a most amazing organ pipe
cactus national monument.
Kitt Peak Wonders
Start out on Arizona State Road 86,
familiar to many locals for its turnAjos historic Plaza is one of the most significant, still preserved
off to visit Kitt Peak National
Spanish Colonial revival style town centers in the country.
Observatory at the junction of AZ SR
386. This road leads you up 12 miles
the turnoff and BIA Route 19). But the Himdag Ki Museum is free
to a summit and the Observatorys amazing showcase of optical
and open to the public, and visitors are able to explore the
telescopes. If youre stopping at the Observatory, remember to
Oodham history, foods and language in the exhibits. Opened in
check the website (see Resource, below) prior to your visit, to
2007, Himdag Ki also includes artist studios, education areas,
learn about special tours or weather notes. Up at the summit
archive storage and collection areas, a hall honoring war
youll enjoy top-of-the-world sky-watching and a beautiful gift
Veterans, a family-history room and spaces for tribal members to
shop with Native American arts.
meet in privacy. It is important to call ahead to the Museum to
learn about what exhibits are open or to request a tour of the
If youre not stopping at Kitt Peak during this journey, youll want
impressive and sustainably-built architecture and archives. The
to continue on SR 86 past the SR 386 turn-off, about 20 more
small complex is in a setting that offers stunning views of
miles, to Sells, the capital of the Tohono Oodham Nation. In town
Baboquivari Peak, the most sacred mountain to the Oodham,
there is a small caf called Desert Rain where you can order a
central to their culture and home to their Creator, Iitoi. This
heart-healthy and native breakfast granola, or lunch stews of local
dramatic landscape is also an unparalleled backcountry climbing
meats and heirloom vegetables. There is no frybread here, but the
adventure for the experienced hiker (again, permits from the
mesquite cookies and prickly pear lemonade are delicious. Check
Nation are necessary).
the website (see Resource, below) for hours. A small gallery and
gift shop adjoin the caf, and here youll find beautiful locallymade native baskets, pottery, jewelry and other arts, in addition to
a small but interesting selection of books and native foods.

Land of Iitoi and Oodham Culture

In Sells, to visit the Tohono Oodham Nation cultural center, you
will continue your travels south onto Bureau of Indian Affairs(BIA)
Route 19, where, after an eight-mile drive through grasslands,
you come to a turn-off to visit Himdag Ki, the Tohono Oodham
Nation Cultural Center and Museum (see Resource, below). The
turn-off in Topawa is easy to miss, so be on the lookout for it, on
your left.
The eastward turn-off is a rutted dirt road (which also leads to
Baboquivari picnic area. A permit to visit Baboquivari park is
required from the Nations office, located at the intersection of

After your Museum visit, you may return to Sells via BIA Route 19,
passing the tiny St.Catherine Mission Church, which was
completed in 1925 by Oodham villagers. Although not in pristine
condition, the church interior deserves a respectful peek to see
interesting statuary and native murals.
Once you are back in Sells, you may continue on AZ SR 86 for your
extended road trip to Ajo. Youll travel approximately 70 more
miles west through wilderness. There are stands of giant
saguaros and sparsely settled Oodham villages along the way.
The road will fork at the town of Why, and at the fork turn right to
Ajo headquarters for your look back into Arizona copper mining
glory days.
Arizona Copper Mining History
Before reaching the small town of Ajo, youll pass the open pit

copper mine, which closed in the

mid 1980s. Once in Ajo, youll notice
that the town is being revived by the
International Sonoran Desert
Alliance (ISDA), an organization
founded in 1993 to represent the
environmental, cultural and art
interests of Anglo-American,
Mexican and indigenous desert
communities (see Resource, below).
The ISDA purchased the historic
town Plaza, and initiated a multiyear revitalization, which has
included a restoration of the Plaza
buildings and implementation of
programs which include food
symposia and special events. ISDA
also has helped spur a number of
local organizations that now support
regional nature, arts and culture.
Ajos historic Plaza is a rare example
of the early 20th century City
Organ Pipe Cactus National Monument just outside the town of Ajo
Beautiful movement, and is one of
attracts thousands of campers and hikers each year.
the most significant, still preserved
Spanish Colonial revival style town
and also accommodates an amazing Sonoran Desert Conference
centers in the country. The grand Curley School anchors one end
Center (see Resource, below), where visitors stay in classroomsof the complex, with its bell-tower uniquely aligned with the bell
turned-guest rooms and are able to explore more about
tower of the nearby century-old mission-style Church. A
Southwest regional foods and culture. For accommodations also
decommissioned train depot, built in 1915, anchors the other
check a local Airbnb hideaway where this author has stayed, just
end of the town Plaza. The Curley School, on the National
steps away from the church (see Resource, below).
Register of Historic Places, has been converted to artist housing
Photo Ops, Car Tours and Art Walks
Ajo is undergoing a renaissance as
an artist and cultural outpost, and
the Plazas center park is currently a
place for Second Saturday arts
walks, local food fests and many
other events, depending on the
month you visit. Check the ISDA
website for the schedule, which
includes an Old Time Fiddlers
gathering in February, Cinco de
Mayo and 4th of July community
events, a September International
Day of Peace parade, and a Santa
sleigh ride in Ajo Plaza during the
winter holidays.

A century-old mission-style church is part of the restoration and revitalization

efforts in the town of Ajo.

Whenever you visit, recreational and

cultural activities abound. A 10-mile
scenic loop drive above the town is
an interesting tour for history buffs
and photographers (get a map from
ISDA or the local Chamber before
you drive it). You may tour the
Historical Society Museum at the
open pit mine lookout. The restored
Plaza also deserves a meander, to
stop in at the local Chamber offices,
a coffee shop and a gallery and print

shop run by the ISDA. Around town, there are murals and art
walks, new age boutique and thrift stores, a home-made donut
shop and additional galleries you can get directions from the
Chamber or ISDA offices. There are historic Ajo buildings steps
away from the Plaza, and the beautiful starry skies afford more
photo opportunities above the local cathedral in the evenings.

Ajo Resource Checklist

If you are looking for a lunch spot youll also want to explore the
Ajo Golf Club (open through May; see Resource, below) and
airfield, which was part of the Army Air Corps prior to World War
II. Lunch in the historic clubhouse is delightful and the grounds
are interesting. Back in town, the 100 Estrella Restaurant has an
impressive assortment of craft beers and Kobe burgers treats (but
check the Facebook page for hours; see Resource, below).
Organ Pipe Opportunities
Beyond Ajos in-town or mining historic attractions, thousands
are drawn here for the camping, hiking, birding and nature
photography in nearby Organ Pipe Cactus National Monument
and the Cabeza Prieta Wildlife Refuge. The immense stands of the
Organ Pipe cactus in the National Monument are beyond
compare, and the Cabeza Prieta Wildlife Refuge, a sanctuary for
endangered desert bighorn and Sonoran pronghorn, is
Organ Pipe Cactus National Monument (see Resource, below) is
about 30 miles south of Ajo, reached from a State Highway 85
turnoff back in Why, which would be your last stop for refueling
and for homey, local pancakes or tacos.
Organ Pipe is included in worldwide UNESCO Biosphere Reserve
system, and is a paradise of rare cactus whose enormous cacti
limbs form a canopy in the desert, reminiscent of their musical
instrument namesake. Their beautiful white funnel flowers
bloom in May and June. Check in at the Visitor Center for maps
and to see the schedule of ranger programs, guided hikes and
talks. Trails are plentiful and well maintained, and a 21-mile
graded, one-way dirt road allows cars to loop the tour at leisure.
The Cabeza Prieta National Wildlife Refuge (see Resource,
below) is the third largest refuge in the country. The Visitor
Center is open weekdays, with a friendly staff eager to let you
know whats happening on the Refuge and the Air Force Range.
All visitors must stop at the Refuge headquarters to acquire a free
permit, and be instructed about potential dangers of traversing
the harsh wilderness. Youll also be required to sign a disclaimer
for traveling limited portions of the Barry M. Goldwater Air Force
Range all perfect spots for capturing glimpses of scenic natural
wonders and well-preserved Native American and mining history.
Be aware: Occasionally the scenic roads are closed, especially
during the summer monsoon season.
Just beyond each switchback in this rugged desert wilderness,
there are surprises of nature, arts, culture and history. Go take a
ride west along AZ SR 86, to discover these surprises and blend it
all into a memorable western adventure.
Monica Surfaro Spigelman is a Tucson writer who has traveled
throughout Arizona and the Southwest.


Kitt Peak National Observatory

AZ State Route 386
Tohono Oodham Cultural Center and Museum
Fresnal Canyon Rd.
Topowa, AZ
Desert Rain Caf and Tohono Oodham Community
Tohono Plaz
Sells, AZ
International Sonoran Desert Alliance (ISDA)
38 W. Plaza, Ajo, AZ 85321
Ajo, AZ
The Sonoran Desert Conference Center
Airbnb in Ajo
Organ Pipe Cactus National Monument
10 Organ Pipe Drive
Ajo, AZ
520-387 6849
Cabeza Prieta National Wildlife Refuge (headquarters)
1611 N. Second Street
Ajo, AZ
Ajo Golf Course
100 Estrella Restaurant


Makols Call

Pharmacy Reps Keep Calories Coming

By Dr. George J. Makol

n early April, I again found

myself sitting in the lobby of
the MGM Grand hotel in Las
Vegas. Like many of you, I try
to get there as often as I can to
visit my money.
Las Vegas not only offers
exciting gambling, but is an epic
music venue, and, perhaps
more importantly, this city is a
foodies delight.
At this particular moment, I
found myself lounging just
across from Wolfgang Pucks
Caf, contemplating the many dining options. Just around the
corner from Pucks, youll find Emerils New Orleans Fish House,
Michelin starred LAtelier de Joel Rubuchons Fine Dining, and, for
the more budget conscious, a food court featuring everything
from Big Macs to Subway sandwiches.
I am absolutely sure that as long as the one-armed bandits and
poker tables had not drained your wallet, this is one of the last
places on earth that one could starve to death. Well maybe not
the last place; the last place would be a doctors office.
When my father practiced general medicine, you could barely
find a potato chip in the office. However he had boxes of drug
samples, monogramed pens, pads and letter openers galore lying
around his desk. No one really seemed to care until about a
decade ago when the goodies given Doctors started to get out of
hand, and in stepped congress.
Congress threatened to legislate the Pharmaceutical Research
and Manufactures of America (PhRMA) out of existence if they
didnt quit giving doctors free pens, pads of paper or trips to
Hong Kong. It may have crossed your mind that these are the
same congressmen who accept tens of thousands of dollars from
lobbyists for their supposed charity golf tournaments, or the
thousands of dollars lobbyists pay to attend weekly congressional
briefing breakfasts. It is worth noting, however, that our
congressmen are not allowed to accept pens that exceed $100 in
value, so, thank goodness, there is no chance that they could be
influenced by such gifts. On the other hand, they did allow the
medical field one small loophole through which you could slip
thousands of calories drug companies were allowed to wine
and dine doctors for educational purposes.
With that as background, lets fast forward to the medical office
of today.
Many mornings these days, you will find so many dropped-off
doughnuts in my office that many of the cops on neighborhood
patrol routinely stop by. One pharmaceutical representative
frequently comes in with cupcakes from Phoenix that are piled so
high with creamy frosting that you would fail your cholesterol test

if it was drawn within 10 days of eating just one of these

confectionery monstrosities. Often, between patient visits,
Starbucks overly-caffeinated and caloric-filled Macchiatos or
Frappes mysteriously appear on my desk.
Just last week, my trusty $.99 Circle K coffee in hand, I rolled into
my Northwest office. I was about halfway through that libation,
when one of my nurses plopped a Starbucks iced coffee on my
desk and said, I bought one for everyone on the staff, heres
yours. So, I quaffed down the hot coffee, followed quickly by the
iced coffee, just in time to see my first patient. When I returned,
there was a Starbucks caramel macchiato on my desk, decaf as if
it mattered, so what can a guy do? I drank it. The rest of the
morning, I felt like I was at a Red Bull aerial competition, but I
didnt need a plane.
Then came lunch. I usually try and quietly make my way to the
caf next door for a healthy Cajun chicken salad, but often on the
way out, I almost trippped on a Mexican buffet complete with
guacamole and even churros for dessert. Every day cookies
appear as if by magic, and cakes drop out of the sky, whipped
cream included. I dont know, I think I prefer the outlawed pencils
and pads of paper monogrammed with company logos. I cant
eat those.
As a physician, I am obviously familiar with the principles of
nutrition. In fact, when single I mastered all four of the basic food
groups: takeout, delivery, dine in, and drive-through. A while ago
during lunchtime my nurses asked if my wife could cook
(apparently they had never noticed how much I like to eat). I said
that I would not have considered marrying even Marilyn Monroe
if she could not cook. They got a big laugh out of that, but then I
recalled those four food groups I learned as a bachelor, and
decided Marilyn wouldve been okay even without culinary skills
Every month or so, an expert is invited to town to give a talk on
allergy or immunology, and, of course, these talks are never held
at the salad bar. More likely, I find myself at a steakhouse that
serves the best garlic mashed potatoes in the world,
accompanied by fresh-baked bread, lobster bisque, and crme
brle to boot. My internist asked me the other day why I could
not lose weight. This is like asking the fox guarding the hen house
where the chickens have gone. If I ever had a smidgen of
willpower, it has obviously let me down.
Now, dont get me wrong, I really enjoy interacting with
pharmaceutical representatives, and I do appreciate that they are
trying to make sure that I never pass out from hypoglycemia. Do
doctors even write more prescriptions after eating doughnuts? Is
there any scientific evidence to back this up?
I actually really miss the good old days of pharmas invitations to
golf, the amusement park tickets for the family, and maybe even
an occasional invite to a concert. Nope, now its just food, food,
and more food, unfortunately my three favorite things. Now, if I
could only find that old pharma-engraved pen I had. I need to
sign off on my column.

In Memoriam

Dr. Brendan P. Phipps 1916-2016

By Dennis Carey

rendan P. Phibbs, MD,

cardiologist, internal
medicine physician and medical
pioneer, died on March 5. He
was 99.

1987. The book was awarded the PEN West Award for Nonfiction
and was nominated for the Pulitzer Prize in non-fiction.
After the war, Phibbs completed his residency in internal
medicine at Presbyterian-Saint Lukes Hospital in Chicago and
earned a Master of Science degree in physiology.

Born Dec. 3, 1916, in New York

City, Phibbs grew up in Chicago.
He earned his medical degree
from Northwestern University
in 1941.

In 1971, Phibbs moved to Tucson to join the Section of Cardiology

at what was then the new University of Arizona College of
Medicine. He joined the Pima County Medical Society and
became chief of cardiology at the Pima County Hospital in 1975.
Referred to as the Kino legend, he helped found Kino
Community Hospital in 1977 and served as its Chief of Medicine
until his retirement in 2006.

He served as a combat surgeon

in the 12th Armored Division of
the United States Army from
Phibbs established Tucsons first mobile cardiac care unit. He also
1942-1945, fighting through the
developed a throat-culture screening program for strep for the
Battle of the Bulge and earning
Tohono Oodham community in Sells, where rheumatic heart
two Bronze Stars. A major, he was one of the first American
disease was the leading cause of death at the time.
physicians to volunteer in the typhus-ravaged Dachau
Phibbs had established a similar program during the 1950s in
concentration camp. Phibbs wrote a memoir of his World War II
ING where he moved with his family in 1952, to practice
experiences, The Other Side of Time, which was published in BUZZWyoming,
internal medicine and cardiology for 20 years
in Casper. He led a crusade against silicosis
and lung cancer among miners in bentonite
and uranium mines, resulting in industryTINNITUS
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and was a member of the board for the
Southern Arizona ACLU for 21 years. In 2012,
the Pima County Medical Foundation
awarded him its PMF Award for the
Furtherance of Medical Education. In 2007,
he received the Herbert K. Abrams Award
from the Nichols Initiative for his life-long
commitment to public health. He authored
several cardiology texts.
Brendan was one of the most interesting
and accomplished individuals that I have
met. said Gordon A. Ewy, MD, professor
emeritus and director emeritus, UA Sarver
Heart Center. He was a hero in World War II,
and a pioneer in several areas of cardiology.
He was the best teacher of
electrocardiography, and had a collection
illustrating almost every arrhythmia known.
He was a personal friend.

Penny Phibbs, his wife of 34 years, died in

Tucson in 1975. Phibbs married Liana
Fernandez de Castro in 1982. They shared
their passions for literature, art and the
outdoors until her death in 2011.
On the few occasions I met Dr. Phibbs, it was
clear he was an accomplished and
inspirational man and a great cardiologist.
This is truly a loss to the Sarver Heart Center
and the Tucson community, said Nancy K.
Sweitzer, MD, PhD, professor of medicine,
chief of cardiology, and director, University of
Arizona Sarver Heart Center.
Brendan was one of the most interesting
and accomplished individuals that I have
met, said Gordon A. Ewy, MD, professor
emeritus and director emeritus of the UA
Sarver Heart Center. He was a hero in
World War II, and pioneer in several areas
of cardiology, including the development
of a system to prevent rheumatic fever
and thus rheumatic heart disease, and one
of the first to advocate treadmill testing
before hospital discharge of all patients
with a heart attack. He was the best
teacher of electrocardiography, and had
a collection of almost every arrhythmia
known. He was a personal friend. One of
the highlights of Priscilla (Ewy) and my
experiences was taking him back to
Europe to visit areas where he had
fought in World War II. He was a true
renaissance man.
Phibbs is survived by his brother Roderic
Phibbs, MD (Jane) and their four sons; by
his children Susan Breznay (George), Henry
Phibbs (Leslie Pedersen), Judith Phibbs,
Hugh Phibbs (Joan Warburton); and seven
grandchildren and two of their spouses.
A memorial service was held in Kiewit
Auditorium at Banner-University Medical
Center in Tucson on March 30. The familys
goal is to create an endowment that will
improve heart health. Details of the
endowment are not available. Checks in
memory of Brendan P. Phibbs, MD, should
be made payable to UAF/Sarver, University
of Arizona Health Sciences, PO Box 245018,
Tucson, AZ 85724.

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520.624.4939 | 888.637.0337

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As a hospice physician, it is
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This is why I became a doctor in
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520.544.9890 |
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PCMS Walk with A Doc is a Saturday Tradition

n a chilled February morning five years ago, the Pima

County Medical Society held its first Walk with a Doc event.
A tradition was born at Rillito River Park that happens on the
second Saturday of each month from September through April.
Walk with a Doc is a national organization founded 10 years ago
by Ohio cardiologist David Sabgir, MD who wanted to familiarize

people of all ages to the benefits of regular exercise. His story is a

familiar one in the medical community.
Im a doctor, I graduated, and gosh darn it people will listen to
me! said Sabgir as a hot shot cardiologist right out of med

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Like many fresh docs, he believed that

having a patients best interest at heart and
communicating with them sincerely was
enough to get them to instantly change their
life-threatening habits. Months later, when
his patients returned having made little to no
progress, he scratched his head and
attempted in vain to remove his heart from
his sleeve. In an act of fury, during a
consultation with one of his favorite
patients, he blurted out without much
forethought, Will you go on a walk this
Saturday with me and my family or what?
Or thats how he imagined it went. To
Sabgirs delight the patient, in addition to
the 99 others that Sabgir invited, said yes
and Walk with a Doc was born.
Since that first Walk in 2005, Sabgir has put
his time outside of the office into the Walk.
In its ten years Walk with a Doc has
developed into something that changes the
relationships between community members
and physicians from a scary to-do meeting
into a fun get-to-do Saturday morning
activity by removing as many barriers as
possible to get people up and moving. Docs
and community organizations all over the
country and beyond have found that the
addition of a doctor to a walking group helps
people who havent exercised in years feel
safe enough to take their first intentional
It is unfair not to expose people to this.
Sabgir said.
On a less altruistic level, the Walk gives docs
an outlet that works. Docs often feel
powerless to change the physical activity
habits of their patients. Rather than going
through the pain of prescribing a medication
that will only delay the consequences of a
sedentary lifestyle, the Walk allows docs to

Dr. Shana Semmens, a resident with the Banner University of

Arizona Medical Center, continues a conversation walkers
about Arthritis during the April 9 Walk With A Doc event held at
Rillito River Park.

Dr. Shana Semmens provides a handout on the current

treatments for Arthritis as part of the presentation at the latest
PCMS Walk With A Doc event.

give patients and members of their community a manageable,

effective prescription.
The PCMS-sponsored walks are the only official Walk with a Doc
events in Arizona. They take place at Rillito River Park near Camp
Lowell and Swan Road. Physician leaders give a short
presentation on a subject in their range of expertise. The event
continues with a walk and talk session covering an easy 1.2- or
2.4-mile hike along the parks trail or paved path. Walkers are
encouraged to ask questions and interact with the walk leader.
With more than 218 sites in 40 states across the country the Walk
is working to reverse the consequences of sedentary lifestyles by
educating and empowering individuals to no longer be afraid or
overwhelmed to take control of their health. An annual Walk with
a Doc survey has 92.4% of respondents reporting feeling more
educated since starting Walk with a Doc, 79.4% feel that they get
more exercise, and 78.8% feel more empowered.
PCMS needs walk leaders for its events in 2016-17. Events will be
held on September 10, October 15, November 12, December 10,
January 14, February 11, March 11 and April 8. If you are interested
in participating in the Walk with a Doc program, contact Dennis
Carey at 795-7985 or


Walkers prepare to cross the bridge along the bank of the wash
at Rillito River Park. Walk With a Doc encourages people to
engage in regular exercise and enjoy the unique opportunities
in Tucson.


Navajo Scholarships

UA Colleges of Medicine Establish Scholarship

Fund for Navajo Medical students
By Jane Erikson
Photos courtesy of University of Arizona Health Sciences Office of Public Affairs.

n a March 10 ceremony at the University of Arizona College of

Medicine Tucson, officials with the Navajo Nation and the UA
Colleges of Medicine in Tucson and Phoenix signed an agreement
to establish the Navajo Nation Future Physicians Scholarship

Fund to help more Navajo students pursue careers as physicians.

Navajo Nation President Russell Begaye and Vice President
Jonathan Nez; UA Health Sciences Assistant Vice President for
Diversity and Inclusion Francisco Moreno,
MD; UA College of Medicine Tucson Dean
Charles Cairns, MD; and UA College of
Medicine Phoenix Associate Dean of
Admissions Tara Cunningham, EdD, were
among those who participated in the signing
This agreement is historic for us, Begaye
said. We have never had a relationship with
any medical school anywhere in the country.
And for the University of Arizona to open its
doors and its schools for this to happen is
really phenomenal. We are excited about
seeing seven students enter this program,
and then bringing them home when they are
done with their medical education.

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Cairns called the agreement a major

milestone in the history of the University of
Arizona Colleges of Medicine. This is going to
benefit not just the Navajo Nation and its
students who want to become doctors. Its
also going to benefit all of our students and
faculty by creating a richer and more diverse
learning environment.
Moreno commented: As a medical school
committed to increasing diversity in the
physician workforce, it is a privilege and an
honorto partner withthe Navajo Nation
toestablish this important new scholarship
fund. We know there is a nationwide
shortage of physicians, particularly in rural
areas, and that reservations areamong
thehardest hit. These scholarships will
enable Navajo students to fulfill their
aspirationsof becoming physicians, while
serving as role models for Navajo youth who
want to follow in their footsteps.
At a meeting of UA and Navajo officials
before the signing, Cunningham said, Its
heartbreaking for us to know there are very
bright Navajo students who want to come to
our colleges, but we lose them to other
schools that have been able to offer them
more financial support. Now these students
will know that the University of Arizona
medical schools, both campuses, are
committed to their development. It will

On March 10, the Navajo Nation and the UA Colleges of Medicine

in Tucson and Phoenix signed an agreement to establish the
Navajo Nation Future Physicians Scholarship Fund to help more
Navajo students pursue careers as physicians. Participating in
the ceremony are: (seated left to right): Jonathan Nez, Navajo
Nation vice president; Russell Begaye, president; College of
Medicine - Tucson Dean Charles Cairns, MD; College of Medicine
- Phoenix associate dean of admissions, Tara Cunningham, EdD.
Standing are (left to right): Karen Frances Begay, MA, UA
assistant vice president for tribal relations; and Tanisha
Price-Johnson, PhD, UA College of Medicine Tucson executive
director of admissions and financial aid.

change their trajectory. So this is a very exciting day for us.

Increasing the diversity of the physician workforce is a top priority
for both UA medical schools. The UA College
of Medicine Tucsons Pre-Medical
Admissions Pathway Program (PMAP), gives
students a year of classes and academic
counseling to prepare for the Medical College
Admissions Test. The program seeks to enroll
students from under-represented minority
groups, particularly Native Americans, and
those who have not had the economic and
educational advantages that help other
students qualify for medical school.

Navajo Nation President Russell Begaye speaks about the

historic agreement with the UA Colleges of Medicine to establish
the Navajo Nation Future Physicians Scholarship Fund.

support from the Navajo Nation Future Physicians Scholarship

Fund, and earn their medical degrees, will be required to serve
the Navajo people for a minimum of five years upon completing
their post-MD medical residency programs.
The UA Colleges of Medicine in Tucson and Phoenix will match
the scholarship funds provided to students by the Navajo
Department of Din (Navajo) Education.
Jane Erikson is a Writer/Communications Specialist for the
UA College of Medicine Tucson Telemedicine Programs and
Family Community Medicine.

The UA College of Medicine Phoenix offers

a similar program, the Pathway Scholars
Program (PSP). Both programs are funded
through the U.S. Health Resources and
Services Administration. The agreement
signed today goes into effect July 1 for six
years, when it will be reviewed for renewal.
Other key points of the Navajo Nation Future
Physicians Scholarship Fund include:
The fund will provide financial aid to cover
students tuition, and academic support for
up to seven Navajo scholars per year, to help
them earn a medical degree from the UA
College of Medicine Tucson or the UA
College of Medicine Phoenix.
Current UA medical students will be
eligible for the awards, as will students who
are accepted into the PMAP and PSP
Navajo medical students who receive


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Pima County
Medical Foundation
Speakers Series
May 10:

Biphosponates and Fractures of

the Femur
Dr. Jennifer Schneider.
June 14:

Pain Management 2016
Dr. Ken Gossler.
Sept 13:

Balloon Dilation of the Sinuses,

The Only Constant in Life is Change
Dr. Steven Blatchford.
October 11:

Treatment of Thrombophlebitis

and other Vascular Problems
Dr. Christopher Compton.

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November 16:

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well established Pediatric practice in Tucson, Az.
Competitive salary with excellent benefit package,
including bonus compensation. Send CV to kolleenr@


Doctor of the Day Program

The Arizona Medical Associations (ArMA) Doctor of the
Day program offers a wonderful opportunity to enhance
the visibility of the medical profession and gain greater
credibility with the elected officials whose decisions
affect the practice of medicine in Arizona. Physicians
representing ArMA as Doctor of the Day provide
invaluable medical assistance should any emergency
arise at the Capitol complex, and our staff coordinate
their ability to attend committee meetings, watch
sessions of the House and Senate, and meet with
individual legislators to advocate for your profession and
your patients.
If youre a member of ArMA and would like to
participate, please contact PCMS Exec. Director Bill
Fearneyhough at

Annual Screening Mammography

Why start at age 40?
Radiology Ltd. stands firmly behind its recommendation
that women should receive yearly mammograms starting
at age 40 in order to receive the maximum benefit from
breast cancer screening.
Radiology Ltd.s local data from 2007-2014 shows that 14%
of cancers detected by screening mammography were in
women ages 40-49. Nationally, 40% of the life years lost
to breast cancer are in women diagnosed in their 40s.

Please call and request

your 3D Mammo today!
(520) 733-7226
For more information
about this and other
screening exams provided
by Radiology Ltd., please
visit our websites at or




MICA was founded in

1976. This year we are
celebrating our 40th
anniversary. We have grown
and prospered because of our dedication and commitment to our
members our policyholders. As a mutual insurance company,
our policyholders are our beneficial owners. We do not have
stockholders who benefit from our success. Our members share
in our success, and our decisions are based on their interests.


Medical Professional
Liability Insurance
(602) 956-5276
(800) 352-0402