Sun, surf – and free health care

Joanne Kenen

About Joanne Kenen

Joanne Kenen, (@JoanneKenen) the health editor at Politico, is AHCJ’s topic leader on health reform and curates related material at healthjournalism.org. She welcomes questions and suggestions on health reform resources and tip sheets at joanne@healthjournalism.org. Follow her on Facebook.

Photo: Courtesy of Volunteers in MedicineDr. Jack McConnell with a patient.

So what does a wealthy doctor who retired and moved to a beach and golf community off the South Carolina coast do when he gets bored with golf?

He rounds up a bunch of his golf buddies – also retired docs – and launches a free clinic.

That’s what Dr. Jack McConnell did in the early 1990s. Today, the Volunteers in Medicine group that he founded operates about 90 partner clinics in more than half the states. Even after passage of the Affordable Care Act, gaps in coverage and affordability – particularly in states that did not expand Medicaid – mean the clinics remain needed and busy. The doctors, nurses and dentists who volunteer at these clinics have served hundreds of thousands of people.

NBC’s Tammy Leitner recently profiled the clinic McConnell founded in Hilton Head, a wealthy resort enclave that still has its share of people in need, including many service workers in the tourism industry and their families.

“We’re caring for some of the most medically underserved people in the country,” McConnell says in the piece. “And when you go home at night, you really feel good about that.”

“VIM’s protocols treat the symptoms, educate the patient in self-care and monitor the patient to maintain wellness,” according to the Hilton Head clinic’s website. “VIM offers family practice, internal medicine, as well as lab, X-ray and ultrasound services, pharmacy, mental health and dental care in a total of 23 medical specialties and five disease management clinics.”

The website also has a (slightly out-of-date) position paper supporting the ACA; these are not conservative do-gooders arguing that the government should get out of health care and let the private sector/philanthropic sector do the job.

I found it interesting to read about the clinics’ and their policies. (The VIM website includes a history section, geographic list, donor information, and links to each clinic’s website.)

The short TV piece did leave me with some questions (not the fault of the correspondent – she had limited time). But profiling some of these clinics in your state may be interesting –and it is not just a feel-good piece. There are a lot of good hooks about the uninsured, the ACA, primary care, and the practice of medicine. For example, regarding the patients:

  • Which of them would otherwise be left behind by the nation’s health care system, and why? Does a family member have insurance at work but coverage for dependents is too expensive?
  • What did these patients do before the free clinic was available? Are some eligible for Medicaid/Medicaid expansion but don’t know it? Ditto for access to ACA subsidies. Were they scared away some of the anti-ACA rhetoric about premiums and deductibles?
  • Alternatively, do they just prefer these volunteer clinics – do they get something more from doctors and nurses who are there only because they want to be?

More about the care:

  • How advanced or complex a case can be handled?
  • Can patients have an ongoing relationship with one doctor or nurse, or do they see someone new each time? That may not be a big deal for a sprained ankle or strep throat, but potentially more important for a patient managing chronic conditions such as diabetes or CHF.
  • What happens to patients who need more extensive treatment, such as hospitalization or chemotherapy? Does the clinic have any partners that do free- or reduced-fee care?

The physicians ought to have some great stories too:

  • Given that they are older and may not have practiced full time for a while (and may practice very part-time as a retiree), how do they keep their skills up to date? Do they take CME (continuing medical education) and is that a state requirement? Does the clinic pay their malpractice insurance?
  • What did they miss about medicine? Did they treat a lot of poor people before retirement? If not, do they regret it? Is this more rewarding than their more remunerative phase of their careers? What keeps them doing it? And when will they stop?

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