Under the provisions of the federal Liability Risk Retention Act, RRGs domiciled in one state can operate in other states upon filing a registration application notifying nondomiciliary states of their intent to do so.

A theme among the physician RRGs is that the traditional market is not meeting their needs.

For at least one of the new RRGs, the medical malpractice market in one of its states, New York, is in crisis. There, the state's residual carrier--the Medical Malpractice Insurance Pool--is running a total deficit of approximately $1.9 billion.

What's more, a task force appointed by New York Gov. Eliot Spitzer, charged with finding solutions to New York's ongoing medical malpractice insurance financing problems, failed to make a year-end deadline to issue a report.

For other RRGs, the motivation stems from a desire to control their own programs and achieve long-term rate stability. Many doctors have learned this is not possible with traditional insurers, which reduce rates in soft markets and raise them in hard markets--sometimes to exorbitant levels.

Another motivating factor for physician RRGs is finding out--typically through feasibility studies--that their loss experience does not warrant the rates they have been paying to traditional insurers.

Insurers often group them with high-risk specialties, so the physicians are, in effect, subsidizing higher risk doctors.