Want to help improve access? Become a volunteer
By Sara Walker, MACP
When James B. Reuler, FACP, began his internal medicine career in Portland, Ore., he was committed to providing free medical care for uninsured patients. Eighteen years ago, with a bequest from a patient, this former Governor for the Oregon Chapter founded the nonprofit Wallace Medical Concern.
Today, the Concern operates three affiliated clinics located in a single-room occupancy hotel, a shelter for homeless youth and a building in a Spanish-speaking community. With more than 225 physicians, medical students and other volunteers, the clinics fulfill a real and growing need.
Increasing numbers of parents who have lost their jobs and insurance join regular clients who need charity care for themselves and their children. Lines start forming two hours before the clinic doors open. (For more on Dr. Reuler's work, see "From a small bequest, help for thousands of homeless.")
Halfway across the country in Chicago, Serafino G. Garella, FACP, also wanted to help uninsured inner-city residents. In 1993, Dr. Garella, the College's Governor for the Illinois Northern Chapter, founded a volunteer-based free health care clinic where 143 physicians and other volunteers provide care six days a week.
CommunityHealth today occupies a renovated, century-old candy factory on Chicago's west side and accommodates about 16,000 patient visits a year. Nearly 75% of the patients come from working families.
The efforts of the Wallace Medical Concern and CommunityHealth are being duplicated all over the country. There is an increasing need for volunteers to patch together a safety net for the growing population of uninsured Americans who cannot afford basic health services. To help address this country's deeply troubling access problems, College members of all ages and levels of experience are rising to the challenge.
Some, like Drs. Reuler and Garella, establish volunteer clinics. Others treat thousands of needy patients free of charge in their offices, or give countless hours of expert care in charity settings.
The need for volunteers is particularly apparent to seasoned internists, who have first-hand experience with the terrible problems of the uninsured. Internists nearing retirement are often especially interested in volunteer service as a satisfying, hassle-free way to draw on their deep stores of experience and keep their clinical skills sharp.
Volunteerism is a vital component of the College's goal of increasing access to health care for all Americans. The College's Credentials Subcommittee considers volunteerism so important that it is an important criterion for advancing to ACP-ASIM Fellowship.
In 1997, the late Oscar E. Edwards, MACP, founded the ACP-ASIM Volunteerism Work Group. Under the leadership of current Chair Stephen M. Salerno, FACP, the group encourages College members to participate in volunteer projects and provides information about volunteer opportunities. (For more information on the Volunteerism Work Group or the Oscar E. Edwards Award, contact Jean Elliott, Awards Committee Administrator, at firstname.lastname@example.org or 800-523-1546, ext. 2692.)
Would-be volunteers typically have two questions: Where can I find a clinic that needs me, and how do I handle liability insurance?
The answer to the first question is simple: There are a wealth of opportunities in hundreds of clinics and organizations all over the country, which are bulging at the seams with people in need of care.
The answer to the second question is more complicated. For their own legal protection, medical volunteers must make sure that they meet state-mandated licensure and liability-protection requirements. Some clinics have worked out plans to provide malpractice insurance, while others depend on practitioners to provide their own individual coverage.
Licensing requirements and statutory protections for pro bono medical workers differ from state to state. At present, eight states have no charitable immunity laws. In other states, however, physicians are given substantial protection from lawsuits, the state provides malpractice liability insurance, or volunteers are considered state employees. (For more information, see "Resources to help you get started," below.)
At Convocation Ceremony on April 11, 2002, the College recognized Dr. Reuler by presenting him with the Oscar E. Edwards Award for Volunteerism and Community Service. At the same ceremony, Dr. Garella accepted one of two Richard and Hinda Rosenthal Foundation Awards on behalf of CommunityHealth.
Drs. Reuler and Garella and thousands of other dedicated medical volunteers have truly made a difference in the lives of others. Their selfless work inspires us to do our part to care for increasing numbers of medically bankrupt Americans.
In a recent conversation, Dr. Reuler said that volunteers will have to play a critical role until this country has a national health program. "All of us who provide free health services have a goal of closing up shop at charity clinics," he said. "In countries with a national health program, these are not needed because everyone has access by virtue of living in that country."
ACP-ASIM Online offers information on volunteering as a physician at www.acponline.org/hpp/volunteer.htm. A brochure, "Interested in Volunteering as a Physician? A Guide for Getting Started," contains links to other Web sites and a discussion of legal issues.
Volunteers in Health Care, a project funded by the Robert Wood Johnson Foundation, provides a wealth of information on organizing and expanding volunteer medical clinics for the uninsured. The organization can steer you to products and programs that serve the uninsured, as well as associations of free clinics. Volunteers in Health Care also provides free consultations to individuals or organizations interested in helping the uninsured.
The group also publishes the Charity Immunity Manual, which provides a detailed and helpful review of U.S. charitable immunity legislation for volunteer health care providers. You can order a free version online by accessing Volunteers in Health Care on the Web or by calling 877-844-8442. You can also get updates on legislation and new laws that affect charitable immunity by clicking on the Legislative Happenings button at the top of the site's homepage.
Annual Session presentation. The challenges and rewards of volunteering were presented at a panel discussion at Annual Session 2002, "Volunteering as a Physician: Opportunities, Challenges and Rewards." An audiotape of the session includes information on changing state laws to protect medical volunteers and is available online at www.soundimages.net.
Want to help a colleague or friend get involved as a volunteer? Try posting this article on the bulletin board at your practice, training program or hospital lounge. Printable versions of this article are online.
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