ARIZONA MEDICAL BOARD

FISCAL YEAR 2006-2007
ANNUAL REPORT

9545 East Doubletree Ranch Road
Scottsdale, Arizona 85258
(480) 551-2700 or toll-free (877) 255-2212
www.azmd.gov

TABLE OF CONTENTS
Letter to the Governor, Janet Napolitano …………………………………………..……….. Page 2
.
ARIZONA MEDICAL BOARD
Board Membership ………………………………………………………………………….. Pages 3-6
Board Accomplishments…….………………………………………………………………

Page 7

Licensing ……………………………………………………………………………...……… Page 8
Regulation ………….………………………………………………………………………… Pages 9-10

Page 1

LETTER TO THE GOVERNOR
JANET NAPOLITANO

Governor
Janet Napolitano

Members of the Arizona Medical Board
William R. Martin, III, M.D.
Chair/Physician Member
Douglas D. Lee, M.D.
Vice Chair/Physician Member
Dona Pardo, Ph.D., R.N.
Secretary/Public Member/R.N.
Patrick N. Connell, M.D., FACEP
Physician Member
Dan Eckstrom
Public Member
Robert P. Goldfarb, M.D., FACS
Physician Member
Patricia R. J. Griffen
Public Member
Ram R. Krishna, M.D.
Physician Member
Lorraine L. Mackstaller, M.D.
Physician Member
Paul M. Petelin, Sr., M.D.
Physician Member
Germaine Proulx
Public Member
Amy J. Schneider, M.D., FACOG
Physician Member

Executive Staff
Timothy C. Miller, J.D.
Executive Director
Amanda J. Diehl, M.P.A., C.P.M.
Deputy Executive Director
Roger Downey
Media Relations Officer

D

ear Governor Napolitano:
On behalf of the Arizona Medical Board, I
submit to you our 2007 Annual Report.

Last year, we reported the tremendous improvement
we had made in redesigning our investigative/adjudicative process
and our licensing process. The results were a spectacular success
with the Board meeting all of its performance measures for the entire year.
The Board is now turning its attention outward, toward the
community. During this past year, the Board has developed guidelines for pain management and a Substantive Policy for Internet
Prescribing.
For the upcoming year, the Board will continue its involvement in providing guidance to the community and working with
the community. Just a few of the projects the Board is working on
include: the implementation of Office-Based Surgery Rules; guidelines for physicians on complimentary and alternative medicine;
recommendations for physicians on the supervision of physician
assistants; and development of a program with the Arizona Partnership for Implementing Patient Safety (APIPS) and Health-e Connections.
We believe these new rules, guidelines and the substantive
policy statement will enhance patient safety, while helping physicians understand what the Arizona Medical Board expects.
Sincerely,

Timothy C. Miller
Executive Director

Page 2

ARIZONA MEDICAL BOARD MEMBERSHIP
William R. Martin, III, M.D., the
Board’s Chair, is a Board-certified Orthopedic
Surgeon at Copper State Orthopedics, Ltd., Phoenix,
Arizona. In addition to his
busy private practice, he
helps to provide Orthopedic
services for Children’s Rehabilitative Services (CRS), and
for the poor and the medically indigent populations
both in the inner city and on Native American
Indian Reservations. Dr. Martin is also the medical director of Urgent Care+, LLC, Phoenix, Arizona.
Dr. Martin is a member of the American Academy of Orthopaedic Surgeons (AAOS) and has a
dual appointment on the Academy’s Diversity
Advisory Board and on the Council on Advocacy.
Dr. Martin is a lifetime member of the National
Association for the Advancement of Colored
People. He is a member of the American Medical
Association, the Arizona Medical Association,
and the Arizona Orthopaedic Association. Dr.
Martin received his medical degree from Loyola
University of Chicago in Maywood, Illinois.

Douglas D. Lee, M.D., the Board’s
Vice-Chair, is a Board-certified Anesthesiologist
practicing in Flagstaff, Arizona.
He graduated from the University of Arizona School of Medicine, completed an internship at
the National Naval Medical
Center in Bethesda, Maryland
and a residency at the Naval
Regional Medical Center in San
Diego, California. From 1980 to
1981, Dr. Lee was a United States Marine General
Medical Officer in Okinawa, Japan, and he was
also a reservist called to serve in the Desert
Shield/Desert Storm 1st Marine Division from
1990 to 1991.

In addition to his professional experience, Dr.
Lee is a member of the Arizona Society of Anesthesiologists and a member of the American
Board of Anesthesiologists. He previously served
as the Chairman of Anesthesia for the Flagstaff
Medical Center (FMC), President of the FMC
Medical Staff, and President of the Arizona Society of Anesthesiologists. He currently serves as a
Staff Anesthesiologist at FMC and Managing
Partner of Forest County Anesthesia, PC. He is
also a Board Member of the FMC Ambulatory
Surgery Center and a member of the FMC Credentials Committee.

Dona Pardo, R.N., Ph.D., the Board’s
Secretary, is a public member and a registered
nurse. Dr. Pardo has over 30
years experience in nurse education and has taught in diploma, associate degree, baccalaureate degree and continuing
education programs. She recently retired from the University of Arizona after 21 years of
service during which she taught
baccalaureate nursing students, headed the Continuing Education program in the College of
Nursing, and just prior to retirement was the Administrator Continuing Education for the Arizona
Health Sciences Center. In that post, she was
responsible for Continuing Education for physicians and nurses.
Dr. Pardo is 2nd Vice-President of the Board of
Directors for Compass Healthcare, and founding
Foundation Director and current Treasurer for
Tucson Nurses Week Foundation.
Dr. Pardo earned her master’s degree in nursing
from the University of Texas Health Sciences
Center at San Antonio and holds a doctorate in
higher education from the University of Arizona.
Page 3

ARIZONA MEDICAL BOARD MEMBERSHIP
Patrick N. Connell, M.D., has recently
retired from an active urban emergency department practice. He currently is
working part time in the Pediatric Emergency Department at
Maricopa Medical Center, and
as a volunteer physician in Central America. Dr. Connell has
worked with the American College of Emergency Physicians
as a member of their Practice
Management Committee and assisted in policy
development for the College. He is a past president of the Arizona College of Emergency Physicians and has served on their Board for ten years.
Dr. Connell has been a Fellow of the American
College of Emergency Physicians since 1983.
Dr. Connell received his medical degree at the
University of Arizona and performed his residency in surgery at University Hospital in Tucson.
.

Dan Eckstrom, a public member of the
Board, is the President of DWE Management
Consultants, Inc. in Tucson.
He is a former Pima County
Supervisor who served the
citizens of District 3 for 15
years. He stepped down
from that post in 2003.
Before his success at the
county level, Mr. Eckstrom
was first elected to the South
Tucson City Council in 1971 at the age of 23. At
the time, he was one of the younger elected officials in Arizona. He also served as the city’s
mayor.
Mr. Eckstrom is active in the community. He is
the organizer/conference moderator of
“Strengthening Arizona Families through FaithBased and Community Initiatives Conference”;
the founder/member of Meth Free Alliance; a
board member of the Pima County Workforce

Investment Board Faith Based Subcommittee; a
member of the C-Path Institute National Advisory Board; and a member of the United States
Army Reserves.
Mr. Eckstrom has a Bachelor of Arts Degree in
Government from the University of Arizona in
Tucson.

Robert P. Goldfarb, M.D., FACS, graduated from Tulane University, School of Medicine
and practices in a Tucson,
Arizona NeurosurgeryNeurology specialty group
practice and serves as President of the group practice.
Dr. Goldfarb also is the Neurosurgical Consultant to the
University of Arizona Athletic
Teams and is a Clinical Associate Professor in the Department of Surgery,
College of Medicine at the University of Arizona.
Dr. Goldfarb completed his Internship at Michael
Reese Hospital and Medical Center in Chicago
and his Residency in Neurological Surgery at the
University of Illinois Hospitals and PresbyterianSt. Luke’s Hospital in Chicago. He is certified by
the American Board of Neurological Surgery and
is a Fellow of the American College of Surgeons.
He has previously served as Chief of the Medical
Staff at Tucson Medical Center and is currently a
Member of the Board of Trustees at El Dorado
Hospital and a member of several professional
societies including the American Association of
Neurological Surgeons (Harvey Cushing Society),
Congress of Neurological Surgeons, American
Medical Association, North American Spine Society, Arizona Medical Association, and the Pima
County Medical Society.

Page 4

ARIZONA MEDICAL BOARD MEMBERSHIP
Patricia R. J. Griffen, a public member
of the Board, is the founding Executive Director
of Against Abuse, Inc., established in October 1981 to provide domestic violence and
child abuse shelter services to
the citizens of Pinal County.
She received her Bachelor of
Science Degree in Social Administration from the University
of Arizona.
Ms. Griffen has more than 35 years experience in
the field of private, non-profit management. This
includes her role as a founding member of Arizona Coalition Against Domestic Violence and
formerly serving as a member of the organization’s Board of Directors. She is a state and local
speaker on a wide range of domestic violence and
child abuse issues.
Ms. Griffen is currently the secretary of the Pinal
County Victim Compensation Program, the Chair
of the City of Casa Grande Personnel Advisory
Board, and the Chair of the Desert Pavilion Advisory Board.

Ram R. Krishna, M.D., is an orthopedic surgeon who is currently in private practice in
Yuma and was formerly the
chief of surgery at Yuma Regional Medical Center. Dr.
Krishna served as chair of
the Yuma Regional Medical
Center Board of Trustees
and as president of the Yuma
County Medical Society.
Currently, he is a member of
the Arizona Orthopedic Society and the Arizona
Medical Association. Dr. Krishna was awarded
the Arizona Medical Association’s Distinguished
Service Award in 2000 for his exceptional work in
the community.

Boards on the Board of Directors for the Educational Commission for Foreign Medical Graduates.
He obtained his medical degree from Bangalore
University Medical College in Bangalore, India.
He did his internship, a one-year residency in general surgery and a four-year residency in orthopedics at the University of Massachusetts Medical
Center.

Lorraine Mackstaller, M.D., began her

medical career as a Registered Nurse at St. Joseph’s Hospital in Phoenix, and
then thirty years later earned
her M.D. at the University of
Arizona in Tucson. She performed her residency in internal medicine at the University
of Arizona and is currently on
staff at the Sarver Heart Center
in Tucson. She is Board certified in internal medicine and
specializes in cardiovascular disease.
Dr. Mackstaller has served on the Board of the
American Heart Association, the Sarver Heart
Center Advisory Board, the University Heart
Center Board, the National Scientific Internal
Medicine/Family Practice Advisory Board, the
Hilton Head Health Institute, and the Arizona
Commission on Women’s Health.
Dr. Mackstaller has taught classes at the University of Arizona College of Medicine, lectured on
women’s health and heart issues, and authored
numerous medical journal articles. In 2003, Dr.
Mackstaller received the Patients’ Choice Award
from the University Medical Center in Tucson.

Dr. Krishna has been elected to serve as the representative of the Federation of State Medical
Page 5

ARIZONA MEDICAL BOARD MEMBERSHIP
Paul M. Petelin, Sr., M.D., is a Boardcertified surgeon in private practice in Phoenix.
He received his medical degree
from Creighton University
School of Medicine in Omaha,
Nebraska, and has a Bachelor’s
Degree in Chemistry from
Gonzaga University in Spokane, Washington. Dr. Petelin
completed his internship and
residency at St. Joseph’s Hospital and Maricopa Medical Center in Phoenix.
From 1984 to 1988 and again from 2000 to 2004,
Dr. Petelin was Chief of Surgery at St. Joseph’s
Hospital. He is in his second term as governor of
the State of Arizona American College of Surgeons. He is a member of the Board of Directors
of the Phoenix Surgical Society, and is a past
president of that organization. He also serves on
the Board of Directors of the Arizona Medical
Association.

Germaine Proulx, a public member of
the Board, is a certified Pharmacy Technician
who lives in Sedona with her
family. She has been very
involved in her community
since she and her husband
moved there in 1977.

Mrs. Proulx is a graduate of Scottsdale High
School and attended Northern Arizona University
in Flagstaff.

Amy J. Schneider, M.D., FACOG, is a
Board-certified Obstetrician-Gynecologist in Tucson where she is the
Medical Director and
Partner in Grace Maternity & Women’s Health.
She has held an Arizona
medical license since
2001.
Dr. Schneider received
her medical degree from Tulane University
School of Medicine in New Orleans in 1997. She
did her internship and residency at the Department of Obstetrics and Gynecology at the University of Arizona Health Sciences Center in Tucson. She earned her Bachelor of Science Degree
from the University of Oregon.
Dr. Schneider is a member of the Physicians
Leadership Group at Northwest Hospital in Tucson and a member of the Tucson Society of
Women Physicians.

Mrs. Proulx has served on
the Board of Directors for
the Sedona Adult Community Center and helped establish the Meals on
Wheels program. She has served as President of
the West Sedona PTA and as a Girl Scout leader.
She has been a member of the Parish Council at
St. John Vianney Catholic Church where she is on
the Finance Committee. She has also served on
the Joint Legislative Committee on Hunger.
Page 6

BOARD ACCOMPLISHMENTS
The Arizona Medical Board reached a “tipping point” at the beginning of
the fiscal year, bringing under control the internal issues that had allowed a buildup of cases and lengthy investigations. That progress allowed the Board to focus
on external issues that confront patients and the medical community.
At its September 2006 Offsite Strategy Meeting, the Board made a series of recommendations relating to physician supervision of physician assistants.
Response to this led to the formation
of a subcommittee of the Arizona Regulatory
Board of Physician Assistants that began
work on updating the rules for PA supervision. The PA Board will consider the Subcommittee’s Supervision Draft Rules at its
August 2007 meeting.
Once approved, the two Boards will
harmonize their positions on physician supervision of physician assistants.
In December 2006, the Board approved a Substantive Policy Statement (SPS)
to provide guidance to and educate physicians
on the law regarding Internet Prescribing.
In its policy statement, the Board
states that on-line questionnaires do not meet
the legal requirement for an established doctor-patient relationship prior to prescribing.
The SPS explains the standard of
care required when prescribing drugs or
medical devices; recognizes the law regarding
prescribing; identifies Internet prescribing and
the problems associated with it; distinguishes
Internet prescribing from e-Prescribing and
Telemedicine; and concludes with the Board’s

position on the requirement to properly establish a physician-patient relationship prior
to issuing a prescription. Physicians establish their relationships with patients by obtaining an accurate and thorough medical
history and conducting a physical examination.
Growing concern about the under
treatment of chronic pain led the Board to
approve amended Pain Management Guidelines for physicians that also apply to physician assistants.
The purpose of the guidelines is to
create an environment in which physicians
are encouraged to administer controlled substances in the course of treating chronic pain
without fear of disciplinary action when such
treatment is provided within the accepted
community standard of care.
And, at its June 2007 meeting, the
Board adopted the amended Office-Based
Surgery Draft Rules that now proceed
through the final rule approval process.
A Board subcommittee began working with stakeholders on these rules for physicians who perform surgical procedures
involving conscious sedation in their offices
in 2005.

Page 7

LICENSING
The Arizona Medical Board now has nearly 19,000 physicians licensed to
practice medicine; as many as 11,000 have Arizona office addresses.
The then-Arizona Board of Medical Examiners began licensing medical doctors in 1903,
nine years before Arizona became a state. The
Board issued certificates to practice medicine and
surgery to 198 physicians the first year, charging
them a licensure fee of $2.00.
The Board kept its licensure records in
The Great Register, writing in the names of licensees
as they were approved.
By 1936, when the Board printed its first
Medical Directory, there were 619 licensees—420
of them practicing within the state.
Times have changed, and so have fees
and records. Information on licensed physicians

is maintained in databases in the Board’s computer system. The $500 biannual licensure fee
supports the Arizona Medical Board’s licensing,
investigative, and administrative functions.
The Board conducts primary source verifications on educational and training programs
and performs national queries to determine if a
physician has any professional conduct issues in
other states. Although providing the proper
documents is the responsibility of each applicant,
Board Staff help physicians with the verification
process to reduce the overall timeframe for licensure.

Licenses Issued
FY 06

FY07

Licenses Issued

1,429

1,458

Post Graduate Training Permits Issued

1,140

1,248

Miscellaneous Licenses Issued

77

92

Dispensing Certificates Issued

489

428

2

1.1

99%

99%

Average Number of Days to Issue a License (Date of receipt of fully
completed application to final approval)

Customer Satisfaction Rating

Page 8

REGULATION
A complaint lodged against a physician triggers a process that the Arizona
Medical Board has restructured to ensure a fair and impartial investigation,
while striving for a timely resolution.
When an investigation uncovers a violation of the Medical Practice Act, the Arizona
Medical Board uses its authority to discipline
those licensees who violate the law.

In the end, the Board is bound by its charge
to protect Arizona citizens from the unlawful and
incompetent practice of medicine. The actions the
Board takes are reflective of that mission.

Disciplinary actions taken against a licensee
are public, and the effect these actions can have
on a physician are long-lasting. For that reason,
the Board takes all complaints against physicians
seriously, and the decision to issue discipline is
based on a thorough, fair and accurate investigation.

Overall, the Board took disciplinary action in
142 cases (see chart below) during FY 07. In 42
other cases, the Board ordered non-disciplinary
measures for physicians such as practice litmitations based on health problems, in addition to
the 122 cases that resulted in the issuance of nondisciplinary Advisory Letters.

FY 07 Board Actions
90
79

80
70
60
50
40
30

26

26

20
8

10

3

2

0

Loss of
License

Practice
Restriction

Decree of
Censure

Letter of
Reprimand

Probation

License Denial

Page 9

REGULATION
The Arizona Medical Board’s regulatory activity begins when a complaint
is opened.
The Board opens an investigation only when
a complaint meets two criteria: it is against an
allopathic physician and the allegation—if true—
would be a violation of the Medical Practice Act.
The caseload of open investigations reached a
manageable and stable level of approximately
300-340 cases during the 2007 fiscal year, which
represents a 23% drop in the number of cases still
open at the end of FY2006.
Investigations Remaining Open at
Fiscal Year End
Year

Number

2006

422

2007

326

Fewer cases allowed Board Staff to complete
investigations more quickly, while improving the
quality of the investigations. The FY2007 average
represents a 40% decrease in the amount of time
needed to complete an investigation.
Average Days to Complete an Investigation
Year

Days

2006

201

2007

119

Compliance Monitoring is the Board’s
method for ensuring physicians comply with
Board orders. The Compliance figure represents
the number of physicians being monitored for
these reasons. Compliance officers conduct random practice audits, review physician records and
report to the Board any findings of noncompliance. Failure to obey a Board order can
lead to more disciplinary action.
Compliance Monitoring
Year

Cases Monitored

Compliance

165

MAP

94

Other PHP

29

Additionally, physicians who are in the
Board’s Physician Health Program (PHP) can be
in either the Monitored Aftercare Program (MAP)
for substance abuse rehabilitation or in the
“other” part of the PHP for medical, psychiatric,
psychological or behavioral health issues. PHP
coordinators ensure that physicians comply with
the program’s requirements and are safe to practice medicine. Findings of non-compliance are
immediately brought to the agency’s attention.

Page 10