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The Power of Unity: A Closer Look at Organized Medicine Through the Eyes of Arizona's Physician Leaders

By Dominique Perkins, Associate Editor, Arizona Physician

Photography by Noble Pictures, jeffnoblepictures.com

From Print Issue - Winter 2024
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In today’s healthcare landscape, where policies are increasingly shaped far from the examining room, organized medicine ensures that the voices of physicians—and the needs of patients—remain central to the conversation. From advocating for physicians’ rights to influencing policies that directly affect patient care, organizations like the Arizona Medical Association (ArMA) and the Maricopa County Medical Society (MCMS) are indispensable to Arizona’s healthcare system.

 

But what does “organized medicine” mean in practice? How can physicians harness their collective strength to enhance their profession and improve patient outcomes? These questions led us to conversations with two influential physician leaders: Nadeem Kazi, MD, Board President of ArMA, and Jane Lyons, MD, Board President of MCMS. Their insights highlight the challenges and opportunities facing Arizona physicians and the critical role organized medicine plays in shaping the future of healthcare.

 

A LEGACY OF COLLABORATION AND LEADERSHIP

Organized medicine in Arizona dates to 1892, when MCMS was founded to address the challenges of frontier healthcare. That same year, MCMS leaders, including Dr. Joshua Miller, helped establish ArMA, creating a unified voice for physicians across the state.

 

Over the decades, ArMA and MCMS have tackled evolving challenges—from early licensing standards to today’s complex healthcare policies. This legacy of collaboration remains vital, especially as Arizona grapples with issues like physician shortages, administrative burdens, mental health, and healthcare access disparities.

 

“That’s what I call organized medicine,” Dr. Kazi said. “We all sit together, come from all over the state or the country, and talk about our issues, how to deal with them, how to manage them, and how to solve the problems that our colleagues and our patients are facing.”

ArMA, with its structured advocacy programs, PACs, and legislative resources, leads these efforts. They ensure that healthcare professionals’ voices are heard and that their concerns are addressed at the legislative level. MCMS, on the other hand, is dedicated to advocacy and policy, with a focus on raising awareness and fostering connections among members. By offering tools and resources, MCMS empowers its members to stay informed, engaged, and active in their practice. Together, both organizations work to ensure that healthcare professionals have the support and resources they need to navigate medicine and influence policy decisions.

 

“Organized medicine is also there to provide support to each other, and to support our practice, to support us as physicians to make sure we are able to provide the best quality healthcare that we can,” states Dr. Lyons.

ADVOCACY: THE VOICE OF PHYSICIANS AND PATIENTS

One of organized medicine’s most critical roles is advocacy. ArMA and MCMS work to influence legislation, reduce administrative burdens, and champion patient care.

 

“Healthcare in America is so complex, with so many competing interests, that we’re really here to be the voice for physicians and patients,” says Dr. Lyons. “So much of what we do in the examining room is decided by non-physicians—at the courts, at the state capital. Physicians must be at the table to ensure that laws and policies serve patients and the healthcare system.”

 

Shortly after completing his gastroenterology fellowship, Dr. Kazi’s colleague encouraged him to visit Arizona. “He convinced me to come for a year—I literally came to Arizona, to Casa Grande, for one year!” he said. “That was 27 years ago. I fell in love with the people.”

 

Dr. Kazi recalls witnessing a plethora of issues, including the high number of young people experiencing advanced liver disease and cancer. He and his professional colleagues encountered challenges within the healthcare system that motivated him to become actively involved in organized medicine at both the county and state levels.

 

“We started fighting for insurance reform, payment reform, and I thought, you know, ArMA is doing a lot,” he said. Asked what prompted her passion for advocacy and organized medicine, Dr. Lyons recalls a pivotal moment during her first quarter of medical school, when she took an elective titled The Politics of Medicine.

 

“My teacher opened my eyes to what happens in medicine that isn’t in the patient-physician examining room—all of the legal issues in the courts, all of the legislative issues at the state level and the federal level, issues in health insurance,” she said. “And once your eyes are opened, I think it’s hard to close them.”

 

An oft-quoted phrase from that class stayed with her: “If you’re not at the table, you’re on the menu.”

 

“If we are not actively fighting for our profession, our patients, and healthcare, then we will be on the menu,” she said. “And there will be laws that might hurt physicians, hurt patients, and that can adversely affect the quality of Healthcare in America.”

 

ArMA and MCMS prioritize physician involvement at every level. “One of the big things we’ve been doing is directly connecting our member physicians, our board of director physicians, as well as trainees, residents and medical students with legislatures at the House and the Senate,” she said.

 

Programs like ArMA’s Doc of the Day bring doctors to the Arizona State Capitol during legislative sessions, providing direct input to policymakers.

 

“These guys see a real picture of what’s going on with the debate,” says Dr. Kazi.

 

“I go every year,” adds Dr. Lyons. “We are there to provide medical care and I actually have been called to an emergency before, but you also get to meet your legislatures, you get to tour, you get to talk to the lobbyists, and then you get to sit in on the session, and so it really is amazing, especially if you are just starting to get into this.”

 

These efforts yield tangible results. According to ArMA’s 2024 legislative report, Arizona physicians, united through organized medicine, achieved several legislative victories, including:

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  • Allowing medical assistants to complete prior authorizations ordered by clinicians, reducing administrative burdens.

  • Repealing Arizona’s outdated pre-statehood abortion ban.

  • Expanding protections against delayed insurance payments.

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FIGHTING FOR PUBLIC HEALTH AND THE INTEGRITY OF MEDICINE

Organized Medicine also plays a crucial role in protecting public health, in part by upholding professional standards and ethics, ensuring high quality patient care, and maintaining trust between physicians and the public.

 

“There is a triangle of major points in medicine that we need to focus on—access, quality, and cost,” Dr. Lyons said. “Our goal is to provide the highest quality care, ensure access to the most people, while containing cost. We are there to make sure that with the different laws that are being proposed, and the different court cases, we are asking how they are affecting these three things. Especially expanding access to healthcare and ensuring the highest quality healthcare,” she said.

 

Expanding access to quality healthcare is a prominent concern. In addition to the burdens placed on physicians by ever-increasing administrative duties, delayed payments, denied claims, the increasing financial insecurity of Medicare, and the devastating obstacles of complicated coding, prior authorization blocking patient care, and deliberately complex claims coding, Arizona is faced with a dramatic physician shortage.

 

According to the Cicero Institute, the United States is projected to have 120 thousand too few doctors nationwide by the year 2030. Arizona is currently ranked in the bottom half of all states for primary care and physician availability.

 

Arizona’s physician-to-patient ratio ranks 15% worse than the national average, with every single Arizona county classifying as at least a partial Health Professional Shortage Area (HPSA). HPSA indicates an area where there are 3500 or more patients for every one provider. Low-income citizens and rural areas are disproportionally affected by these shortages.

 

Approximately 3.2 million Arizonans—40% of the state’s population—live in an area with a current health care shortage, according to the Health Resources and Services Administration. A significant reason for this, both in Arizona and across the country, is a lack of residency spots, Dr. Lyons points out.

 

According to the National Resident Matching Program, Arizona has 108 medical resident and fellowship opportunities. For comparison, California has 594. But with a staggering number of seven medical schools in Arizona, that is not enough to keep graduates in-state. Studies repeatedly show that a significant majority of physicians tend to settle and practice medicine in the same state where they completed their residency training.

 

“When you go somewhere else and you spend 3-6 years (for fellowship and residency), you tend to stay there,” Dr. Kazi said. “So that is the problem we are facing: we have a student output, but we don’t have the resident programs or fellowship programs to have a doctor output.”

 

Securing additional Graduate Medical Education funding to open more residency spots will be key to closing this physician gap, as well as introducing incentive programs to encourage physicians to settle in extreme shortage areas.

Dr. Kazi says that securing the needed GME funding for Residencies and finding ways to address the rural healthcare shortage are the two main focuses of his presidency at ArMA.

 

“We have to be very careful,” Kazi said. “What we decide today is going to affect us the next 5-10 years, and that’s where the organized medicine comes in.”

 

“So far, we have achieved good things, but not enough. We are still working,” he said.

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SUPPORT AND RESOURCES FOR PHYSICIANS!

Another pivotal role of organized medicine is to provide resources to help physicians navigate challenges like burnout, practice management, and staying current with medical advancements. They also offer networking opportunities, continuing education, and professional development.

 

As the physician supply lags behind patient demand, patients wait longer to see doctors, and doctors are overwhelmed by a patient load too great to bear. In the face of these challenges, on top of the high pressure and long hours of the profession, it is small wonder that physicians across the state—and the country—are facing record rates of burnout and discouragement. According to a survey published by the American Medical Association (AMA), in 2023, 48.2% of physicians reported experiencing at least one symptom of burnout. The good news is that this is a decrease from 53% in 2022. In fact, this is the first time in four years that the rate has dropped below 50%.

 

Despite this positive step, especially as we continue to recover and move forward after the COVID-19 pandemic, job burnout continues to be a top concern facing doctors today. Most physicians enter the profession due to a passion for the work and feel significant satisfaction in the work they do. However, too often job satisfaction does little to mitigate the extreme stresses placed on them by an increasingly complex and adversarial national healthcare system.

 

The repercussions of this high burnout risk can be dire. In addition to the damage to individual physicians’ physical and mental health, the AMA survey also reports that physician burnout costs the US health care system an estimated $4.6 billion annually. This cost is due to reduced work hours and physician turnover as suffering physicians feel they have no choice but to leave the profession to preserve their own health.

 

“I believe in work-life-balance, it’s a huge issue,” Dr. Lyons said. “This is not a normal or an easy job, or life. But we found a calling to it, and we want to do our best—so organized medicine can help you do that.”

 

MCMS is working to support physicians in a variety of ways, aiming to treat physicians as a whole person. Dr. Lyons describes MCMS member benefits as being both tangible and intangible. She references advocacy efforts and collaborations with ArMA as a less tangible benefit—the effects may not always feel immediate, but the end goal is electing legislators who will be understanding and informed and creating legislation that will act in the best interests of physicians, patients, and healthcare.

 

“We also want to provide tangible benefits,” she said. “We do really want to support our small business groups, our medium groups, our solo practitioners. It is about providing resources in a changing environment.” Among these tangible benefits, she lists MCMS efforts to provide affordable and accessible\ continuing medical education, partnerships with businesses who provide services that support physician practice, utilizing the Arizona Physician publication to connect and inform the physician community, and of course hosting social and networking events to provide much needed community support.

 

“You know, our days are so busy,” she said. “And while we might collaborate with other physicians, we are either passing the baton, or we are working on a shift by ourselves, and then we are not always having that meaningful connection. So really connecting us with other physicians, regardless of specialty—it takes some of that burden from us and relieves that frustration.”

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LOOKING TO THE FUTURE

As uncertain as the future of medicine and healthcare may seem at times, both Drs. Kazi and Lyons believe that organized medicine is not going anywhere and will still be just as essential moving forward.

 

“We have no other option but to be organized and one platform, a united front,” Dr. Kazi said. “Organized medicine has to be there, and we have to make it strong.”

 

To physicians who may feel that their voice is insignificant in the broader healthcare landscape, or to those who believe medical professionals should remain apolitical: both are valid concerns, and they are heard. Dr. Lyons understands that frustration and says, “when the autonomy of our profession is persistently attacked and eroded by those outside of healthcare, we are compelled to act.”

 

“As physicians, we must defend our profession to uphold the medical oaths we have taken to serve patients to the best of our abilities. If our capacity to provide care is jeopardized by those who seek to fracture our healthcare system, it is imperative that we unite.”

 

Together, as physicians and healthcare allies become greater in numbers, Arizona’s medical professionals can collectively strive for a better healthcare system. When physicians local and statewide perspectives are represented in shaping the future of healthcare —a voice for a better tomorrow, starts today. ArMA and MCMS will remain committed to ensuring, as they have done for over century, to support, defend, and protect a thriving medical community and improve outcomes for Arizona patients.

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ABOUT THE AUTHOR: 

Dominique Perkins serves as Associate Editor for Arizona Physician

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