Introducing the Association of American Bi-Cultural Doctors (AABCD) The Association of American Bi-Cultural Doctors (AABCD), a not-for-profit organization, was formed in response to diverging needs of bi-cultural physicians who provide care for the overwhelming majority of the fast growing foreign born population in the US. Many, but not all, of these bi-cultural physicians are foreign born themselves and are committed to serving their own ethnic communities that are in need of physicians who can understand their cultural heritage and converse in their native tongue. These bi-cultural physicians face unique challenges and opportunities in managing their medical practice. The AABCD will strive to help them meet the challenges and take advantage of the opportunities effectively by bringing together a broad base of physicians that can benefit from the solution to a common problem, thereby achieving economies of scale. One such challenge - and opportunity - pertains to medical liability insurance. As explained in the section below titled, "The Foreign Born Population and Medical Liability," the AABCD believes that many bi-cultural physicians are currently paying more than their fair share of medical liability insurance premium because medical liability insurers choose to ignore the fact that many foreign born populations are much less litigious than the American mainstream. The AABCD will strive to realize the premium saving for their members through sharing proprietary analysis and other relevant information with key medical liability insurers or through sponsoring the formation of a new medical liability insurer, if necessary. Please go to AABCD Professional Liability Insurance Program for further details. The AABCD is sensitive to the desire of most physicians to be known as a physician - period - without an unnecessary adjective highlighting their ethnicity. Therefore, they will be judicious by pursuing only those issues whose benefit to the membership will be overpowering as in the case of medical liability insurance. Your support will be critical to the success of the AABCD. Please join us by filling out and returning the Membership Application Form. If you have questions or need additional information, please call 212-643-0003 or email main@aabcd.org. The Foreign Born Population and Medical Liability According to the US Census 2000, the foreign born population accounted for 11.1% (31.1 million) of the total US population (281.4 million) in 2000 and grew 57% from 1990 to 2000. As of 2007, the same growth rate would give approximately 43 million foreign born residents out of 301 million total US residents, or about 14% of the US population. The Association of American Bi-Cultural Doctors (AABCD) commissioned an actuarial study to determine whether foreign born residents filed medical liability lawsuits at a different rate than the native born residents. Since no lawsuit database existed with all the pertinent census information about the plaintiffs, the study targeted only a few ethnic groups - e.g., the Chinese and the Koreans - for which the plaintiff's name alone could easily identify the ethnic origin and whose population base was large enough to yield a meaningful comparison to the native born population. The study found that the target foreign born populations had a very low rate of filing medical liability lawsuits. Their rate was only 30% of the native born population! It could have been even lower considering the study had to classify any plaintiff with the ethnic name as foreign born, thereby overstating the number of foreign born plaintiffs. This is a groundbreaking finding which demonstrates the need for a sizable premium discount for physicians who practice medicine in these foreign born communities. From the insurers' perspectives, these physicians should be viewed less risky, all else being equal, since their patients have been proved to be less litigious. From the practical standpoint, there are two hurdles to overcome before these physicians start reaping economic benefit from the finding: First, objective and socially acceptable rating criteria need to be developed. Use of ethnic origin as a rating variable will not be viewed socially acceptable because such practice will be tantamount to discrimination based on ethnic origin. However, acceptable alternatives exist such as tying premium discount to the usage of foreign languages at the doctor's office and to the types of foreign languages thereby distinguishing languages unrelated to English from those closely related to English. Second, existing medical liability carriers will initially be reluctant to grant the new discount because of their ownership structure - mostly owned by physicians themselves and most of them will have to pay higher premiums to offset the new discount -- and conservative underwriting approach. They probably won't change their approach unless they face competition from a new carrier who will grant such discount. The AABCD will disseminate this finding to medical liability insurers in key states with a large foreign born population such as New York, New Jersey and California, assist them with their own analysis, and exhort them to add a new rating variable to reflect difference in the patients' litigiousness.