American College of Emergency Physicians

Arizona

Recent Reforms Enacted (since 2003)	Requires expert witnesses to be in same specialty as defendant and be board certified if the defendant is. Expert must be in active practice or academic medicine during preceding 12 months. Protects statements of apology, responsibility or sympathy to a patient or family member from being admissible in court. (2005) Requires that liability suits must include an affidavit from a qualified physician within 60 days of filing the suit, confirming there are sufficient grounds. (2004) In 2009, the state enacted legislation increasing the burden of proof required in emergency care cases.
Emergency Care Provision	Clear and convincing evidence (rather than a preponderance of the evidence) required to prove negligence in emergency care cases.
Reform Elements In Law	Joint Liability Collateral Source Expert Testimony Affidavit of Merit I’m Sorry Law Clear and Convincing in Emergency Care Cases
Constitutional Status of Reforms	Ariz. Const. Art. II, sect. 31 prohibits any limitation on recovery of damages. Comparative Fault and collateral source upheld. Affidavit of merit upheld for other professions. In September 2007, a judge ruled that the requirement that expert witnesses must practice in the same specialty is unconstitutional, since it treats medical liability cases differently than other liability cases. In March 2009, the state Supreme Court upheld the state's expert witness law, overturning a lower court ruling.
Change in Insurance Rates	News reports on an increase in rates charged by GE Medical Protective of between 16 and 92 percent in 2004. The primary market medical liability carrier was forced to raise premiums 12.5% in 2003, following a 278% premium increase in 2000.
Insurance Availability	One primary medical liability carrier (a physician owed mutual) insures approximately 75% of the open market.
Change in Physician Availability	As of 2004, AZ physician to population ratio (208/100k) is far below national average of 283/100k.The gap widened by almost 10% since 1990 (AZ was 83% of national average vs. 73.5% in 2004).SOURCE: AZ Physician Workforce Study – 2005 ASU and Univ. of AZ Health Sciences Center. A 2006 survey by Arizona State University showed a 10 percent increase each of the past two years in doctors coming to the state. Researchers also noted that 2,200 more physicians are needed to meet the state's growing demand for health care. Overall, doctors are seeing more patients each week than they did 10 years ago, and the doctor shortage is chronic and particularly acute in rural areas.
Change in Cases Filed/Awards	304 paid claims in 2003 or 24.1 per 1000 active nonfederal physicians. US avg. was 18.8 per 1000. 277 paid claims in 2005 or 21.4 per 1000 active nonfederal physicians. US avg. was 17.1 per 1000. (Kaiser) 216 total number of paid claims for 2006 of which 13.3 paid claims per 1,000 were active, non-federal physicians. 187 paid claims in 2007.