Horizon, Host: Ted Simons

May 15, 2007


Host: Mathew Whitaker

Arizona Stories Tovrea Castle


  • Tovrea Castle was born out of the vision of Italian immigrant Alessio Carraro. Carraro came to Phoenix in 1928 with a dream to build a resort hotel castle surrounded by an exotic cactus garden and a subdivision of deluxe homes. While Carraroís dream of a hotel-resort never came to be, he still built the castle, which was purchased by stockyard mogul E.A. Tovrea in 1931. We tell the story of the unique home and how it became the historic Arizona icon that it is today.
Guests:
  • Dr. Michael Grossman - Arizona Medical Education Consortium
  • Tom O'Halleran - State Senator, Vice-chair, Senate Health Committee, and Chair, Senate Higher Education Committee


View Transcript
Matthew Whitaker:
Tonight on "Horizon", Arizona is the fastest growing state in the nation, and ranks among the lowest for physicians to care for its population. We look at our doctor shortage and efforts to solve the problem. And it began as a dream for a resort hotel surrounded by deluxe homes, but became a place shrouded in mystery. It's now preserved as an historic Arizona icon, Tovrea Castle. That's next on "Horizon".

Matthew Whitaker:
Good evening, I'm Matthew Whitaker, welcome to "Horizon," those stories in a moment. First up, a bill dealing with drunken driving offenders has been passed by the state legislature and sent to the governor for her signature. It requires offenders to use ignition interlocks for at least a year after they get their license to drive back. The device requires a breath test before a vehicle's ignition can be started, and will not operate if the person has a blood alcohol level above .08. State law already mandates that repeat, extreme or aggravated D.U.I.'s. offenders use interlocks when their driving privileges are restored. The bill also ups the sentence from 30 to 45 days of jail time for first-time extreme D.U.I.'s. offenders with blood alcohol of .20 or higher.

Matthew Whitaker:
Our physician-to-population ratio is among the worst in the nation. According to a recent study, in 2005 there were 219 doctors to every 100,000 people in Arizona. Studies also show that physicians who pursue their graduate medical education, or g.m.e. residency program in Arizona, are more likely to stay in the state to practice medicine. The Arizona legislature is considering legislation to increase g.m.e. funding to expand the state's residency programs. Here now to talk more about the physician shortage and how medical funding can improve that shortfall, are Dr. Michael Grossman with the Arizona medical education consortium, senator Tom O'Halleran, vice-chair of the senate health committee, and chair of the senate higher education committee, and Dr. Charles Daschbach, medical director at Saint Joseph's hospital and medical center. Thank you very much for joining us. We have yet another very distinguished group of folks to join us this evening. We'll begin with you, Dr. Grossman. Can you tell us exactly, how much of a shortage do we have?

Michael Grossman:
To determine exactly, I can give you some idea, yes. We've been studying for some years, doctors from a.s.u. have been studying it for years. Using the licensed physicians, both homeopathic and osteopathic in the state of Arizona, and embedded is a questionnaire that helps us feed the data we need to help us look at the types of practices and numbers of patients, et cetera. Superimposed on that is the type of data available that looks at physician encounters and the kinds of services rendered. We've seen that the ratios are very low. the ratios, as you've mentioned, 219 per 200 -- per 100,000, it's clear to us that right now at this moment, despite the fact that in the past two years we've had a significant increase in the numbers of practicing physicians coming to Arizona, we are still somewhere between 2700 and 3,000 physicians short. And the population keeps growing, so this number is a moving target.


Matthew Whitaker:
Doctor, can you tell us what sort of difficulties or problems people are running into because of the lack of physicians and specialists?

Charles Daschbach:
The system that regulates the types of training programs we have is very rigorous and onerous. You just can't open a residency overnight. The requirements are very strict and somewhat difficult to maintain, and they need to be, to protect the public and have somebody well trained in a specific program. We are an importer of physicians from outside the state, but we have things that bring doctors to the state of Arizona. It's really the graduate medical education, the residency programs that produce the physicians who stay in the area. There's a lot of good statistics on that, and for most of the training programs. our ratio of primary care training programs to specialty training programs is about 50\% overall in the state, and it's very competitive to come and train here in Arizona. But it takes tremendous resources to create and sustain training programs.

Matthew Whitaker:
Okay. Senator O'Halleran, do Arizonans in rural areas, are they challenged to travel in extreme cases outside of the state or far from where they are because of these shortages or because of some of these issues?

Tom O'Halleran:
That's a problem for rural Arizona. 219 per 100,000 and Apache County have 40 per 100,000. All these rural counties have much less than the 219 per 100,000. The amount of medical facilities are less, also, hospitals and so forth. Yes, the need to come down to phoenix, our state employees, their insurance plans are different in rural Arizona than urban Arizona. If they come down to phoenix, it costs less for them to deal with the health care network. It is a very big issue.

Matthew Whitaker:
What percentage of Arizona services practice in Maricopa county or Pima county?

Tom O'Halleran:
I don't know that ratio. I imagine one of the good doctors here would know that.

Michael Grossman:
It's an overwhelming number in the urban areas, and those are the two major counties in that regard. Pima county's ratio is somewhere in the 230 per 100,000 range, I believe. Maricopa is not quite that good, but the overwhelming majority do. The disparity between urban and rural areas has always been here. We have been looking at this. We actually had about 10, 15 years ago, a group of us studying this then. There was like 75\% urban and 25\% in the rural areas. And we have some very special problems, too. We have areas, significant areas in our rural regions, where the population base is so small per square mile that it's actually called frontier, which is an interesting classification, less than seven people per square mile. It's an interesting logistical problem to try to bring health care to those populations.

Charles Daschbach:
It's been difficult in the past to get young physicians graduating from programs to go out into rural areas. They're very used to the type of technology they can get in the big city. It takes a special type of person to go out to rural areas. I think that with the technology advancements we have with the internet, the web, and teleconferencing, there's a real hope that doctors in the rural areas won't feel as disconnected when they first go out into practice.

Michael Grossman:
That's an important consideration. the other one we've been experimenting with at the university of Arizona and college of medicine in Tucson has been the rural initiative that took place 12 years -- no, no, about ten years -- where at the end of the first year of medical school, several students request and are sent into rural areas with a mentor who is a practicing physician, usually primary care. And this person remains the mentor of that medical student for the entire medical school career. We are just beginning to collect data now to see how many of the students went through that program, and are now finished with their residency programs, and how many are actually going into rural areas to practice. Right now, if I recall, the data is still a little raw, but looks like about 50\%, but the number isn't large at this point. So maybe we're having an impact on that.

Matthew Whitaker:
And that leads me to a question I wanted to ask you. What information supports the notion or the reality that those who do their residency in the state are more inclined to stay?

Tom O'Halleran:
I think that A.S.U. has a study that says 59\% of residents that come out of our schools here will stay here if they do their residency here in Arizona. It's a national trend, also. People tend to appreciate and get job offers from those locales where they do their residency, so that's why it's so important for us to start to expand that residency process. The legislature over the past few years has paid particular attention to putting more funding forward to get the federal match to be able to deal with that problem.

Matthew Whitaker:
Can one of you tell us more about the graduate education program in general? I mean, give us a better idea of what it entails.

Charles Daschbach:
I can tell you, it's not exactly like you see on television anymore, and I can promise you that. It's not "E.R." Generally students select one of about 24 different specialties to go through in a computer matching program nationally. This matches them to go to a program from three years of training, family practice, or pediatrics, six or seven years. They preselect these careers, and then start making an income as an intern and resident through the years. They're more likely to get more rooted in a community. The process takes a lot of supervision. It's like training airline pilots or nuclear engineers. Teaching hospitals are hotbeds of discussion and academic discourse and things. Some people often say that training residents is a lot like making sausages: the end product is pretty good, but you don't want to see the process going on. I'm kidding a little bit. But these young people are only 25 years old, and they come into these training programs with very dedicated teachers, to get them ready for the day they want to go out and practice.

Michael Grossman:
The ultimate aim is that, at the end of the training, the individual will be able to practice their specialty independently. That's a real big issue. With it also, there's a whole new line of how we are actually training residents, and a whole new curriculum is being put into place. We want to make sure that we have people who are going to have lifelong learning, and the discipline of continuing your education throughout your entire career, with multiple capabilities and resources built into it. And the capability of doing self-reflection, so you know what you don't know, and know what you need to know, and can pursue it.

Matthew Whitaker:
And I have a question about funding. Is the funding for the g.m.e. programs a combination of state funds, federal funds?

Tom O'Halleran:
It's a mixture. We had $22 million two years ago, and we will double that by the end of this legislative session. We did five million last year; we'll do probably three million more. It costs 75,000 to 100,000 for the residency of a doctor. Our ability to catch up with the tide of growth in Arizona is going to be difficult to overcome. That's why we have selected to deal specifically with this area. I think, could we have put more funding in? Yes. We have to catch up with the accreditation process for residency positions in the state, also.

Michael Grossman:
But that 75,000 to 100,000 is per year, per resident.

Tom O'Halleran:
It costs us more to have these teaching facilities and to have residencies at a hospital. You have local hospital funding, private donations, and grants from other private persons.

Matthew Whitaker:
Do matching funds go to the respective state's Medicare program?

Tom O'Halleran:
It handles the arrangements for the residency programs.

Matthew Whitaker:
For new residents, does access go through the rule-making process, and then the hospitals apply for the funding for the residency program?

Charles Daschbach:
Yes, but it's been a collaborative process, with the legislature, the hospital association frankly, and the governor's office and access. They have all worked together in that rule-making process, to make sure there's a fair system of distribution of funds for residency. More importantly, this year through some initial efforts on everybody's part, to help some rural programs get started. and I think it's a clear shared mandate that we all feel, that we have an obligation to do a little bit more, specifically in that area, those of us who train residents.

Matthew Whitaker:
And Senator O'Halleran, can you speak more specifically to some of the things that the legislature is doing to expand funding for G.M.E.?

Tom O'Halleran:
This year we have $3 million in the budget, and that money will be divided into two areas, one for new residency programs, accreditation purposes, and the other one for the rural initiative. Last year we did five million, and a million dollars to go to hospitals to deal with the indirect costs.

Matthew Whitaker:
The senate and house have allocated different amounts. Are they going to reconcile that?

Tom O'Halleran:
They will reconcile that, and I'm more than confident that $3 million will be the final number.

Matthew Whitaker:
Now, do some of these proposed expenditures, funds, include residents' salaries?

Charles Daschbach:
That's part of the hospital. We also get some federal money for educating residents. But in general, the federal funds and the state funds, some of which are matched by federal moneys, make up somewhere about 60\% to 70\% of the total cost we have of our teaching programs. We're still a ways from the point where we can really get some traction to expand as much as we'd like to.

Tom O'Halleran:
That's $44 million, the 60\%.

Matthew Whitaker:
I want to ask you, what are some of the financial challenges that the hospitals have in running a g.m.e. program?

Michael Grossman:
It's a long and arduous process, and they need faculty, resources, high-tech equipment, because you need the ability to do just-in-time or point of care decision-making. You need dedicated people who teach. There has to be protected time for the teaching, which means that's a salary base. There's a tremendous amount of cost in all of this.

Matthew Whitaker:
Thank you.

Charles Daschbach: Now, under new regulations, residents can only work 80 hours a week.

Matthew Whitaker: So a number of people will love to hear that. Thank you very much for joining us, it's been a pleasure.

Matthew Whitaker:
It is Tuesday evening, so we bring you another Arizona story. Tonight, one of phoenix's most visually prominent and stunning landmarks, tovrea castle. producer Merry Lucero and videographer Scot Olson give us look at the story behind this puzzling property.

Merry Lucero:
Tovrea Castle is an intriguing house on a hill east of phoenix. There are almost as many urban legends regarding it as there are saguaros. One tale says this is al Capone's hideaway in the desert.

Mark Lamm:
There is nothing to tie the Chicago mob with the castle, but it made a great story. I think in later years, after the tovreas bought the property and people weren't allowed on the property anymore, it made it all the more mysterious because you couldn't get on the property.

Merry Lucero:
But the myths came along long after the real story began. Tovrea castle was born out of the vision of an Italian immigrant named Elisio Carraro. He came with a dream to build the resort castle hotel, surrounded by a deluxe subdivision.

Barbara Stocklin:
He hired an architect from Texas in 1928, who did some drawings that were actually printed in the newspaper, which showed a pretty elaborate detailed castle.

Merry Lucero:
Carraro purchased 277 acres in an area on the outskirts of phoenix at the time. He envisioned his hotel castle encircled by a lush, exotic cactus garden.

Rilee LeBlanc:
It's sort of an instant desert paradise that he could come in and enjoy every day. That's why it's planted so densely, he just loved it. We want to be able to share this experience with other people for several generations to come.

Merry Lucero:
The site, however, was mostly solid granite. With his son Leo and hired workers, Carraro used a leveler and a rock crusher to grind the granite into gravel for walkways.

Barbara Stocklin:
When you walk around the cactus garden, you'll see all these river stones that are painted white. He apparently sent his crews down to the river, and his son says it was something like 2600 truckloads of river rock from the Salt River.

Merry Lucero:
The 1929 stock market crash forced carraro to scale back, simplify his construction, and be resourceful, using recycled materials inside.

Barbara Stocklin:
The maple floors came from at least one other building that was being demolished in phoenix. The kitchen cabinets came from a bank that was being remodeled, phoenix national bank downtown.

Merry Lucero:
Another salvaged itemfrom the phoenix national bank was a vault placed in the basement as a wine cellar. Also in the basement, this unique ceiling presents an eerie feeling.

Mark Lamm:
I think its part of that basement thing; basements have that kind of a musty feeling. You know, the light isn't as good as you just -- in this one you really feel like you're underground because of that cold plaster ceiling.

Merry Lucero:
Today the interior of the castle remains much like when Carraro built it.

Barbara Stocklin:
The walls are all plaster. He did stencil borders on this floor, as well as art deco light fixtures throughout the building, and they remain. He also had some very decorative plaster work that was done by some Italian plaster workers who were in phoenix at the time to work on the interiors of the Orpheum Theater.

Merry Lucero:
Carraro drew attention to the castle by lighting it up in grand style.

Mark Lamm:
Apparently they went around and dipped all the light bulbs in colored paint, red, blue, green, for Christmas, and then they strapped the trimmed tree to the flagpole, and it was all lit up.

Merry Lucero:
But Carraro's dream of a hotel resort would never come to be. His neighbor, E.A. Tovrea had a stockyard nearby, and who would stay at a resort downwind from a stockyard? carraro had one hope. The property between the stockyard and his castle was for sale and could serve as a buffer.

Mark Lamm:
That property was owned by a Mr. Bates who lived in Globe. Leo swears that his dad was offering the same money that tovrea was, but for some reason the land was sold to the tovreas. The tovreas immediately put in sheep pens.

Merry Lucero:
Exasperated, carraro put his castle up for sale. He sold it to an anonymous buyer in 1931, and moved to San Francisco. That buyer turned out to be E.A. Tovrea. Tovrea bought the castle for his wife Della.

Mark Lamm:
We believe that it was Della that was behind it. They had what would have been a very nice home at the time at 48th and Van Buren. Della wanted the castle on the hill, but they bought it and immediately moved into the castle. Within about nine months of moving in, E.A. passed away, and left Della living here alone.

Merry Lucero:
Della Tovrea lived there until 1969, when burglars broke into her castle and assaulted her.

Mark Lamm:
he slept on a cot in the kitchen, and heard them come in upstairs. She also carried a pistol with her to scare people off the property. She fired the pistol through the ceiling in the kitchen to try to scare them off, but it didn't. She was tied up and beaten up, and the robbery, and passed away a couple of months later.

Merry Lucero:
The castle sat, little used, for decades. In 1993, the city of phoenix, realizing its value to Arizona, began the process of acquiring the property.

Barbara Stocklin:
You wouldn't see this in New England; you wouldn't see this in Texas or California. It's a place that's just truly Phoenix.

Merry Lucero:
The city of phoenix is committed to the restoration and preservation of the tovrea castle and its gardens, making this unique bit of Arizona history a place the public can again enjoy.

Mark Lamm:
Carraro built this to bring people out here, it was a very public place. He even had botanical names on plants in the garden. But when the tovreas bought it, very few people ever saw it. There was always this mysterious building on the hill.

Matthew Whitaker:
We will be featuring "Arizona stories" segments each Tuesday night here on "horizon." and starting June 12th, you can see the new series every Tuesday night at 7:30 p.m.

David Majure:
Arizona lawmakers are considering a state tax breaks for people who use 529 plans to save money for college. We'll also visit the phoenix art museum, where some of the rarest cars in the world are showing off their curves of steel.

Matthew Whitaker:
On Thursday, a look at how the super bowl is helping minority and women-owned businesses get contracts for services. And on Friday, of course, a look at the week's top stories on the "Journalists' Roundtable" edition of "Horizon". Thanks for joining us on this Tuesday evenings. I'm Matthew Whitaker, good night.

Doctor shortage


  • Arizona is the fastest growing state in the nation---- and ranks among the lowest for physicians to care for its population. We look at our doctor shortage and efforts to solve the problem.
Guests:
  • Dr. Michael Grossman - Arizona Medical Education Consortium
  • Tom O'Halleran - State Senator, Vice-chair, Senate Health Committee, and Chair, Senate Higher Education Committee
Category: Medical/Health

View Transcript
Matthew Whitaker:
Tonight on "Horizon", Arizona is the fastest growing state in the nation, and ranks among the lowest for physicians to care for its population. We look at our doctor shortage and efforts to solve the problem. And it began as a dream for a resort hotel surrounded by deluxe homes, but became a place shrouded in mystery. It's now preserved as an historic Arizona icon, Tovrea Castle. That's next on "Horizon".

Matthew Whitaker:
Good evening, I'm Matthew Whitaker, welcome to "Horizon," those stories in a moment. First up, a bill dealing with drunken driving offenders has been passed by the state legislature and sent to the governor for her signature. It requires offenders to use ignition interlocks for at least a year after they get their license to drive back. The device requires a breath test before a vehicle's ignition can be started, and will not operate if the person has a blood alcohol level above .08. State law already mandates that repeat, extreme or aggravated D.U.I.'s. offenders use interlocks when their driving privileges are restored. The bill also ups the sentence from 30 to 45 days of jail time for first-time extreme D.U.I.'s. offenders with blood alcohol of .20 or higher.

Matthew Whitaker:
Our physician-to-population ratio is among the worst in the nation. According to a recent study, in 2005 there were 219 doctors to every 100,000 people in Arizona. Studies also show that physicians who pursue their graduate medical education, or g.m.e. residency program in Arizona, are more likely to stay in the state to practice medicine. The Arizona legislature is considering legislation to increase g.m.e. funding to expand the state's residency programs. Here now to talk more about the physician shortage and how medical funding can improve that shortfall, are Dr. Michael Grossman with the Arizona medical education consortium, senator Tom O'Halleran, vice-chair of the senate health committee, and chair of the senate higher education committee, and Dr. Charles Daschbach, medical director at Saint Joseph's hospital and medical center. Thank you very much for joining us. We have yet another very distinguished group of folks to join us this evening. We'll begin with you, Dr. Grossman. Can you tell us exactly, how much of a shortage do we have?

Michael Grossman:
To determine exactly, I can give you some idea, yes. We've been studying for some years, doctors from a.s.u. have been studying it for years. Using the licensed physicians, both homeopathic and osteopathic in the state of Arizona, and embedded is a questionnaire that helps us feed the data we need to help us look at the types of practices and numbers of patients, et cetera. Superimposed on that is the type of data available that looks at physician encounters and the kinds of services rendered. We've seen that the ratios are very low. the ratios, as you've mentioned, 219 per 200 -- per 100,000, it's clear to us that right now at this moment, despite the fact that in the past two years we've had a significant increase in the numbers of practicing physicians coming to Arizona, we are still somewhere between 2700 and 3,000 physicians short. And the population keeps growing, so this number is a moving target.


Matthew Whitaker:
Doctor, can you tell us what sort of difficulties or problems people are running into because of the lack of physicians and specialists?

Charles Daschbach:
The system that regulates the types of training programs we have is very rigorous and onerous. You just can't open a residency overnight. The requirements are very strict and somewhat difficult to maintain, and they need to be, to protect the public and have somebody well trained in a specific program. We are an importer of physicians from outside the state, but we have things that bring doctors to the state of Arizona. It's really the graduate medical education, the residency programs that produce the physicians who stay in the area. There's a lot of good statistics on that, and for most of the training programs. our ratio of primary care training programs to specialty training programs is about 50\% overall in the state, and it's very competitive to come and train here in Arizona. But it takes tremendous resources to create and sustain training programs.

Matthew Whitaker:
Okay. Senator O'Halleran, do Arizonans in rural areas, are they challenged to travel in extreme cases outside of the state or far from where they are because of these shortages or because of some of these issues?

Tom O'Halleran:
That's a problem for rural Arizona. 219 per 100,000 and Apache County have 40 per 100,000. All these rural counties have much less than the 219 per 100,000. The amount of medical facilities are less, also, hospitals and so forth. Yes, the need to come down to phoenix, our state employees, their insurance plans are different in rural Arizona than urban Arizona. If they come down to phoenix, it costs less for them to deal with the health care network. It is a very big issue.

Matthew Whitaker:
What percentage of Arizona services practice in Maricopa county or Pima county?

Tom O'Halleran:
I don't know that ratio. I imagine one of the good doctors here would know that.

Michael Grossman:
It's an overwhelming number in the urban areas, and those are the two major counties in that regard. Pima county's ratio is somewhere in the 230 per 100,000 range, I believe. Maricopa is not quite that good, but the overwhelming majority do. The disparity between urban and rural areas has always been here. We have been looking at this. We actually had about 10, 15 years ago, a group of us studying this then. There was like 75\% urban and 25\% in the rural areas. And we have some very special problems, too. We have areas, significant areas in our rural regions, where the population base is so small per square mile that it's actually called frontier, which is an interesting classification, less than seven people per square mile. It's an interesting logistical problem to try to bring health care to those populations.

Charles Daschbach:
It's been difficult in the past to get young physicians graduating from programs to go out into rural areas. They're very used to the type of technology they can get in the big city. It takes a special type of person to go out to rural areas. I think that with the technology advancements we have with the internet, the web, and teleconferencing, there's a real hope that doctors in the rural areas won't feel as disconnected when they first go out into practice.

Michael Grossman:
That's an important consideration. the other one we've been experimenting with at the university of Arizona and college of medicine in Tucson has been the rural initiative that took place 12 years -- no, no, about ten years -- where at the end of the first year of medical school, several students request and are sent into rural areas with a mentor who is a practicing physician, usually primary care. And this person remains the mentor of that medical student for the entire medical school career. We are just beginning to collect data now to see how many of the students went through that program, and are now finished with their residency programs, and how many are actually going into rural areas to practice. Right now, if I recall, the data is still a little raw, but looks like about 50\%, but the number isn't large at this point. So maybe we're having an impact on that.

Matthew Whitaker:
And that leads me to a question I wanted to ask you. What information supports the notion or the reality that those who do their residency in the state are more inclined to stay?

Tom O'Halleran:
I think that A.S.U. has a study that says 59\% of residents that come out of our schools here will stay here if they do their residency here in Arizona. It's a national trend, also. People tend to appreciate and get job offers from those locales where they do their residency, so that's why it's so important for us to start to expand that residency process. The legislature over the past few years has paid particular attention to putting more funding forward to get the federal match to be able to deal with that problem.

Matthew Whitaker:
Can one of you tell us more about the graduate education program in general? I mean, give us a better idea of what it entails.

Charles Daschbach:
I can tell you, it's not exactly like you see on television anymore, and I can promise you that. It's not "E.R." Generally students select one of about 24 different specialties to go through in a computer matching program nationally. This matches them to go to a program from three years of training, family practice, or pediatrics, six or seven years. They preselect these careers, and then start making an income as an intern and resident through the years. They're more likely to get more rooted in a community. The process takes a lot of supervision. It's like training airline pilots or nuclear engineers. Teaching hospitals are hotbeds of discussion and academic discourse and things. Some people often say that training residents is a lot like making sausages: the end product is pretty good, but you don't want to see the process going on. I'm kidding a little bit. But these young people are only 25 years old, and they come into these training programs with very dedicated teachers, to get them ready for the day they want to go out and practice.

Michael Grossman:
The ultimate aim is that, at the end of the training, the individual will be able to practice their specialty independently. That's a real big issue. With it also, there's a whole new line of how we are actually training residents, and a whole new curriculum is being put into place. We want to make sure that we have people who are going to have lifelong learning, and the discipline of continuing your education throughout your entire career, with multiple capabilities and resources built into it. And the capability of doing self-reflection, so you know what you don't know, and know what you need to know, and can pursue it.

Matthew Whitaker:
And I have a question about funding. Is the funding for the g.m.e. programs a combination of state funds, federal funds?

Tom O'Halleran:
It's a mixture. We had $22 million two years ago, and we will double that by the end of this legislative session. We did five million last year; we'll do probably three million more. It costs 75,000 to 100,000 for the residency of a doctor. Our ability to catch up with the tide of growth in Arizona is going to be difficult to overcome. That's why we have selected to deal specifically with this area. I think, could we have put more funding in? Yes. We have to catch up with the accreditation process for residency positions in the state, also.

Michael Grossman:
But that 75,000 to 100,000 is per year, per resident.

Tom O'Halleran:
It costs us more to have these teaching facilities and to have residencies at a hospital. You have local hospital funding, private donations, and grants from other private persons.

Matthew Whitaker:
Do matching funds go to the respective state's Medicare program?

Tom O'Halleran:
It handles the arrangements for the residency programs.

Matthew Whitaker:
For new residents, does access go through the rule-making process, and then the hospitals apply for the funding for the residency program?

Charles Daschbach:
Yes, but it's been a collaborative process, with the legislature, the hospital association frankly, and the governor's office and access. They have all worked together in that rule-making process, to make sure there's a fair system of distribution of funds for residency. More importantly, this year through some initial efforts on everybody's part, to help some rural programs get started. and I think it's a clear shared mandate that we all feel, that we have an obligation to do a little bit more, specifically in that area, those of us who train residents.

Matthew Whitaker:
And Senator O'Halleran, can you speak more specifically to some of the things that the legislature is doing to expand funding for G.M.E.?

Tom O'Halleran:
This year we have $3 million in the budget, and that money will be divided into two areas, one for new residency programs, accreditation purposes, and the other one for the rural initiative. Last year we did five million, and a million dollars to go to hospitals to deal with the indirect costs.

Matthew Whitaker:
The senate and house have allocated different amounts. Are they going to reconcile that?

Tom O'Halleran:
They will reconcile that, and I'm more than confident that $3 million will be the final number.

Matthew Whitaker:
Now, do some of these proposed expenditures, funds, include residents' salaries?

Charles Daschbach:
That's part of the hospital. We also get some federal money for educating residents. But in general, the federal funds and the state funds, some of which are matched by federal moneys, make up somewhere about 60\% to 70\% of the total cost we have of our teaching programs. We're still a ways from the point where we can really get some traction to expand as much as we'd like to.

Tom O'Halleran:
That's $44 million, the 60\%.

Matthew Whitaker:
I want to ask you, what are some of the financial challenges that the hospitals have in running a g.m.e. program?

Michael Grossman:
It's a long and arduous process, and they need faculty, resources, high-tech equipment, because you need the ability to do just-in-time or point of care decision-making. You need dedicated people who teach. There has to be protected time for the teaching, which means that's a salary base. There's a tremendous amount of cost in all of this.

Matthew Whitaker:
Thank you.

Charles Daschbach: Now, under new regulations, residents can only work 80 hours a week.

Matthew Whitaker: So a number of people will love to hear that. Thank you very much for joining us, it's been a pleasure.

Matthew Whitaker:
It is Tuesday evening, so we bring you another Arizona story. Tonight, one of phoenix's most visually prominent and stunning landmarks, tovrea castle. producer Merry Lucero and videographer Scot Olson give us look at the story behind this puzzling property.

Merry Lucero:
Tovrea Castle is an intriguing house on a hill east of phoenix. There are almost as many urban legends regarding it as there are saguaros. One tale says this is al Capone's hideaway in the desert.

Mark Lamm:
There is nothing to tie the Chicago mob with the castle, but it made a great story. I think in later years, after the tovreas bought the property and people weren't allowed on the property anymore, it made it all the more mysterious because you couldn't get on the property.

Merry Lucero:
But the myths came along long after the real story began. Tovrea castle was born out of the vision of an Italian immigrant named Elisio Carraro. He came with a dream to build the resort castle hotel, surrounded by a deluxe subdivision.

Barbara Stocklin:
He hired an architect from Texas in 1928, who did some drawings that were actually printed in the newspaper, which showed a pretty elaborate detailed castle.

Merry Lucero:
Carraro purchased 277 acres in an area on the outskirts of phoenix at the time. He envisioned his hotel castle encircled by a lush, exotic cactus garden.

Rilee LeBlanc:
It's sort of an instant desert paradise that he could come in and enjoy every day. That's why it's planted so densely, he just loved it. We want to be able to share this experience with other people for several generations to come.

Merry Lucero:
The site, however, was mostly solid granite. With his son Leo and hired workers, Carraro used a leveler and a rock crusher to grind the granite into gravel for walkways.

Barbara Stocklin:
When you walk around the cactus garden, you'll see all these river stones that are painted white. He apparently sent his crews down to the river, and his son says it was something like 2600 truckloads of river rock from the Salt River.

Merry Lucero:
The 1929 stock market crash forced carraro to scale back, simplify his construction, and be resourceful, using recycled materials inside.

Barbara Stocklin:
The maple floors came from at least one other building that was being demolished in phoenix. The kitchen cabinets came from a bank that was being remodeled, phoenix national bank downtown.

Merry Lucero:
Another salvaged itemfrom the phoenix national bank was a vault placed in the basement as a wine cellar. Also in the basement, this unique ceiling presents an eerie feeling.

Mark Lamm:
I think its part of that basement thing; basements have that kind of a musty feeling. You know, the light isn't as good as you just -- in this one you really feel like you're underground because of that cold plaster ceiling.

Merry Lucero:
Today the interior of the castle remains much like when Carraro built it.

Barbara Stocklin:
The walls are all plaster. He did stencil borders on this floor, as well as art deco light fixtures throughout the building, and they remain. He also had some very decorative plaster work that was done by some Italian plaster workers who were in phoenix at the time to work on the interiors of the Orpheum Theater.

Merry Lucero:
Carraro drew attention to the castle by lighting it up in grand style.

Mark Lamm:
Apparently they went around and dipped all the light bulbs in colored paint, red, blue, green, for Christmas, and then they strapped the trimmed tree to the flagpole, and it was all lit up.

Merry Lucero:
But Carraro's dream of a hotel resort would never come to be. His neighbor, E.A. Tovrea had a stockyard nearby, and who would stay at a resort downwind from a stockyard? carraro had one hope. The property between the stockyard and his castle was for sale and could serve as a buffer.

Mark Lamm:
That property was owned by a Mr. Bates who lived in Globe. Leo swears that his dad was offering the same money that tovrea was, but for some reason the land was sold to the tovreas. The tovreas immediately put in sheep pens.

Merry Lucero:
Exasperated, carraro put his castle up for sale. He sold it to an anonymous buyer in 1931, and moved to San Francisco. That buyer turned out to be E.A. Tovrea. Tovrea bought the castle for his wife Della.

Mark Lamm:
We believe that it was Della that was behind it. They had what would have been a very nice home at the time at 48th and Van Buren. Della wanted the castle on the hill, but they bought it and immediately moved into the castle. Within about nine months of moving in, E.A. passed away, and left Della living here alone.

Merry Lucero:
Della Tovrea lived there until 1969, when burglars broke into her castle and assaulted her.

Mark Lamm:
he slept on a cot in the kitchen, and heard them come in upstairs. She also carried a pistol with her to scare people off the property. She fired the pistol through the ceiling in the kitchen to try to scare them off, but it didn't. She was tied up and beaten up, and the robbery, and passed away a couple of months later.

Merry Lucero:
The castle sat, little used, for decades. In 1993, the city of phoenix, realizing its value to Arizona, began the process of acquiring the property.

Barbara Stocklin:
You wouldn't see this in New England; you wouldn't see this in Texas or California. It's a place that's just truly Phoenix.

Merry Lucero:
The city of phoenix is committed to the restoration and preservation of the tovrea castle and its gardens, making this unique bit of Arizona history a place the public can again enjoy.

Mark Lamm:
Carraro built this to bring people out here, it was a very public place. He even had botanical names on plants in the garden. But when the tovreas bought it, very few people ever saw it. There was always this mysterious building on the hill.

Matthew Whitaker:
We will be featuring "Arizona stories" segments each Tuesday night here on "horizon." and starting June 12th, you can see the new series every Tuesday night at 7:30 p.m.

David Majure:
Arizona lawmakers are considering a state tax breaks for people who use 529 plans to save money for college. We'll also visit the phoenix art museum, where some of the rarest cars in the world are showing off their curves of steel.

Matthew Whitaker:
On Thursday, a look at how the super bowl is helping minority and women-owned businesses get contracts for services. And on Friday, of course, a look at the week's top stories on the "Journalists' Roundtable" edition of "Horizon". Thanks for joining us on this Tuesday evenings. I'm Matthew Whitaker, good night.

What's on?

Content Partner:

  About KAET Contact Support Legal Follow Us  
  About Eight
Mission/Impact
History
Site Map
Pressroom
Contact Us
Sign up for e-news
Pledge to Eight
Donate Monthly
Volunteer
Other ways to support
FCC Public Files
Privacy Policy
Facebook
Twitter
YouTube
Google+
Pinterest
 

Need help accessing? Contact disabilityaccess@asu.edu

Eight is a member-supported service of Arizona State University    Copyright Arizona Board of Regents