A Brief Look at Southern Arizona Medical History and the Pima County Medical Society

Physicians were in short supply during the Spanish, Mexican and early Anglo periods of Tucson’s history.  While Cabeza de Vaca – fresh off arrow removal surgery in western New Mexico – and Coronado’s barber surgeons may have come through Arizona, western medical techniques were mainly herbal and mainly introduced by Jesuits and later Franciscan priest-missionaries.  At its height, Hispanic Arizona only had a scattered population of 1,000 (not counting Native Americans), hardly fertile grounds for a medical practice.  The northern frontier did not attract physicians anyway.  By the time of the Gadsden Purchase, only three physicians served all of Sonora – a state that included Tucson and boasted a population of 200,000.

Anglo physicians went through Southern Arizona with the Mormon Battalion in 1846 and as Forty-Niners during the Gold Rush with little lasting impact. The first doctor to stay any time in the area was a military surgeon named Bernard John Dowling Irwin.  He arrived in 1856 and performed the first recorded surgeries in Southern Arizona.  He also commanded troops during the Battle of Apache Pass – winning the Medal of Honor.

Before, during and after the Civil War a handful of doctors came, more in search of mines and business opportunities than patients.  All had more than one job.  For example, Dr. Edward Phelps was a physician and U.S. marshal…until stole the federal payroll and was killed by bandits in Mexico.

Tucson’s first hospital was established by the military in two locations downtown.  It moved out of town when Fort Lowell was founded.  Tucson’s next hospital, St. Mary’s was not built until 1880.

By the late 1870s enough physicians were practicing in the area that a call went out to form a medical society.  The July 13 Arizona Daily Star announced a meeting would be held July 29 at 2:00 p.m. at the offices of Dr. Mariano Samaniego for the purpose of forming a county medical association.  All regular physicians were invited to attend.  It is believed that this idea lost steam after Dr. Samaniego’s nephew was killed two months; later by a stray bullet and the doctor relocated to Juarez.

Although the medical community remained small, excellent physicians came through Tucson.  We recall Dr. Walter Reed, George Goodfellow and Henri Matas.  Others were nearly of the same caliber, if of smaller renown.  Maricopa county created a medical society in 1891 and the Arizona Medical Association was created in 1892.  Pima County had to wait another decade for a society of its own.

PCMS was founded in response to several national changes.  In 1901 the AMA voted to reinvent itself.  It decided to end its war with competing schools of medicine and to create a federation of medical societies based on the US congressional model.  It soon became an ethical mandate to either join or found a county medical society in order to feed delegates to the state association, and from there, to the AMA.

Arizona Medical Association voted in 1902 to adopt the AMA model, but not much happened.  A new vote in 1904 at the Santa Rita Hotel in Tucson confirmed the previous vote and urged the creation of county societies.

On October 13, 1904 a meeting was held at the office of W.V. Whitmore MD.  A constitution was drafted and adopted.  Dr. Whitmore was elected President.  A.W. Olcott MD was elected vice president and Dr. J.W. Lennox of Helvetia was elected secretary.  Drs. Rodgers, Purcell and Crepin were declared members.  Another physician H.W. Fenner MD was probably there.  He was the second to sign the constitution and is the first member listed on the rolls.  He was also the AMA member in charge of getting county societies started in Arizona.  Dues were $2.

Missing from the initial member rolls were two area homeopaths, an osteopath and the sole woman practitioner.  Rosa Goodrich Boido MD never became a member, although she became, in 1903, the first licensed physician in Tucson.

Early Meetings of the society were annual but the topics discussed were interesting.  The doctors banded together to set fees in order to face down insurance company efforts to cut fees.  Soon the meetings took on a scientific flavor, with members reading papers on various conditions and diseases.  Strong stands were taken against abortion and in favor of a state medical lab – both adopted by the Legislature.

Tucson got two new hospitals, the Whitwell and the Rodger’s, which still stand but have been put to use as other businesses.

During World War I Society members served on the draft board and in active service.  The Society paid the dues of members called to serve.

The Spanish Flu and soldiers returned to the Old Pueblo at the same time.  Dr. Thomas met his old acquaintance from Oklahoma, Dr. Davis, and lured him to Tucson to start Thomas Davis Clinic.  Soon TB and lung diseases replaced the flu as people flocked to Tucson to recover their health.  Harold Bell Wright recovered here and wrote an influential book that lured many.  A tent city sprang up and St. Lukes in the Desert and the Comstock Hospital served the residents living there.  For the better off Desert San, later TMC, was established in the late 1920s and used heliotherapy to fight TB. So many former military moved to town that a public health service hospital was formed at Pastime Park and by the end of the 1920s a Veteran’s Hospital was built on South Sixth, a move long supported by PCMS.  Another hospital, Southern Pacific, was established on the corner where today’s new federal courthouse stands.

Scientific meetings continued apace at the society, but it also opposed a city sales tax on physician services, helped the Red Cross get established and purchased subscriptions to the AMA health magazine for area charities and schools.  Questionable medical practices were pursued with authorities and the Society refused to endorse the notion that Tucson’s climate alone was healthful.  Dues were $25 per year and most meetings were held at the Old Pueblo Club.  At the end of the 1920s, PCMS helped establish a city/county health department, but were soon feuding with that department because so many patients were getting immunized for free.

The decade’s end saw Society founder W.V. Whitmore MD convicted of narcotics fraud.  He was either paroled or pardoned and returned to Tucson forgiven and beloved.  A school was named for him in 1960.

The Depression hit the low wage town of Tucson hard.  PCMS supported using federal CWA funds to enlarge and modernize the county hospital and handled how to staff that hospital with members providing service gratis.  Later it became the medical governing body of the county hospital.  It operated an advisory “Tumor Clinic” free of charge to educate and advise patients about options.  It welcomed Planned Parenthood to Tucson and sat on the advisory Board.

The Society hosted meetings of all southwest physicians and established an executive committee to handle the Society business.  Many physicians were brought from California to lecture on current topics.  Meetings were held at different hospitals around town.

In January 1932 the PCMS Alliance was founded. Dues were $1 and there were 44 members.  At first meetings were social (bridge) and educational, but by the end of the decade they were making food baskets for the needy and sewing for the kids at the Preventorium (a school/home for kids of lung cases located near the Gilbert Ray Campground in the Tucson Mountains).

World War II arrived unexpectedly for Americans in the form of Pearl Harbor.  Dr. Victor Gore was called to do an emergency operation in early 1942 on a Japanese national.  Later he learned the patient was a member of the Honolulu consular staff being held at a guest ranch near Benson.

Young doctors volunteered or were drafted and many pioneer physicians found themselves back on the front lines of patient care.  Many physicians saw the southwest for the first time while in the service and kept it in mind for after the war.

TMC became a community hospital in 1943.  Physicians trained at St. Mary’s and Southern Pacific hospitals.

After the war Tucson began to boom.  Many superbly trained physicians came to town for the weather or the health of their family members or themselves, This continued a long pattern.  Tucson was long known as “specialist’s town” whereas Phoenix was known as a “generalist” city.  The Holbrook Hill Clinic began to develop a national reputation.

PCMS fought President Truman’s plan to nationalize health care, assessing members a special $25 assessment.  The Society also decided to incorporate.  It also decided to make it a requirement of membership to serve for free – and when called – at the county hospital.  Since all Tucson hospitals made it a rule that physicians had to belong to the county society in order to be on staff, the county hospital had its pick of physicians to care for the indigent.

Many remember the 1950s sweetly and physicians here do, too.  It was a happy medical community, armed with new drugs and talents in an expanding town.  Physicians lived near one another, vacationed together even shared a love of cabins on Mount Lemmon.  If there was split it was between the young Turks and the old guard.  A competing association, the Galen Society, was briefly formed to compete with PCMS but gradually the young doctors returned to the fold.

PCMS held its 50th anniversary in 1954 at the El Conquistador Hotel on Broadway.  There were 220 members (retired and active) who received invitations to the memorable evening.

Tucson grew from 45,000 to 212,000 during the decade.  A new hospital envisioned as St. Mary’s East was planned throughout the decade.  It eventually became St. Joseph’s, and opened in 1961.

Maricopa County Medical Society bought a building and hired an Executive Director in 1952.  PCMS hired a secretary, Mary Lamphear and began renting office space on Jackson Street downtown.  Dr. Metzger died in 1957 and left his house to PCMS to sell and build its own headquarters.  That would take 25 years before his dream was realized.

Arizona was growing in the 1960s and decided it needed a medical school.  The Volker report suggested the school should go in Tucson because the UA was the strongest academic campus.  Throughout the sixties Phoenix kept trying to win back the school, but the first class began, sitting on packed microscope cases, in 1967.

In a loud, big meeting, PCMS terminated its relationship with the county hospital in 1961.  The county had hired several physicians and this began a resentment that led to the close vote.  PCMS did not abandon its community spirit, however.  The next year PCMS physicians bought polio vaccine and vaccinated school kids for free.  Tucson was declared the first polio-free metro area in the nation.

Medicare was an overarching issue for much of the middle of the decade.  PCMS sent a delegation with a better plan to Washington.  They received a polite hearing and Medicare passed.

PCMS also aided Blue Cross during this decade, sending representatives to Phoenix to aid in rate setting and to mediate disputes.

The medical community grew by four times during this decade, from 250 physicians to almost 1,000.  The medical society began publishing Sombrero magazine to keep everyone in the loop.

The 1970s saw continued growth in Tucson.  Three new hospitals, El Dorado, Kino and University Medical Center, were built.  Arizona had rejected adoption of Medicaid and there was a growing number of uninsured in the lower middle class.

PCMS helped start an HMO and created a Foundation for Medical Care.  Part of the Foundation was an agreement to set fees very low for the uninsured.  The state launched its first antitrust suit ever against the Pima County and Maricopa County medical foundations.  PCMS signed a consent decree with the state never to offer a health plan again, but Maricopa County fought the suit all the way to the US Supreme Court.  Unfortunately, Maricopa County lost the suit and set the precedent that any time physicians join together to set fees it is antitrust no matter what the circumstances.

Another Tucson case had national ramifications…Tucson General was sued for not overseeing a surgeon.  Hospitals said they had no responsibility to oversee staff that it was merely a tool for physicians to use. The judge found the hospital partly responsible, and the case became widely cited.  The credentialing headache today stems, in part, from this decision.

On a better note, the Auxiliary began the Meals on Wheels program in Tucson.  The UA began heart transplants and the cancer center was founded.

When miners struck southern Arizona copper mines in the early 1980s, the mines and the state hit back – hard.  PCMS started Project Concern and treated miners and their families for free.  President Reagan later cited the medical society for its volunteer spirit.

By that time PCMS had a new headquarters.  It built its building with a special $500 assessment of the members, causing a 20% membership drop.

After a shaky start, Arizona’s version of Medicaid (AHCCCS) began as a managed care model.  Managed care demonstrations in Medicare and home-grown products like Intergroup and Healthpartners made Tucson one of the most penetrated managed care towns in the nation.  Still, a new hospital, Northwest, sprang up in the burgeoning area.

PCMS reinvented Sombrero magazine.  Under editor Eloise Clymer it became an award winning journal.  The Auxiliary started the Human Adventure Center which became the Tucson Children’s Museum.

The 1990s was the decade many physicians fell out of love with medicine.  It became a hurried mess, where patients had their doctors selected for them, where health plans required prior authorization and new cuss “words” like DRG, PCP, UR HCFA entered the lexicon.  Thomas Davis and Tucson Clinics disappeared and Group Health Medical Associates broke up.  Tucson General Hospital went out of business although the Tucson Heart Hospital started operation.

As health care became more expensive the numbers of uninsured rose.  PCMS was the lead organization in two initiatives to raise AHCCCS eligibility from 33% to 100% of the federal poverty line.  Both campaigns were run on a shoestring.  People all over the state came to appreciate PCMS as a champion.

PCMS tried to centralize credentialing in Tucson and come up with a single form to be used throughout the state.  The venture ended when others realized there was money to be made in the venture.

Tucson began to see a physician shortage.  Attracting doctors to Tucson was a tough sell even with the city’s rapid growth.

As PCMS enters its second century many problems remain. Will there be enough physicians?  Are we prepared for terrorism and other medical emergencies?  Can the ACA be improved or should it be replaced?  Can Medicare be reformed to meet the needs of the next generation?

There is reason to be hopeful.

PCMS has never had a better relationship with congressmen and legislators. Longtime member Dr. Michael Hamant will become president of the Arizona Medical Association this year, while two of our long-time members serve on the Arizona Medical Board.  We can also boast that one of our members served as U.S. Surgeon General – Dr. Richard Carmona.

PCMS is involved, active and prepared for the challenges.  It will always be ready with the question, “Can we help?”  And then be ready to go to work.