Medical Volunteers Offer Free Care Nationwide

It was a freezing winter morning in Bloomington, Ind., and retired orthopedic surgeon Rajih Haddawi was driving to the Volunteers in Medicine of Monroe County clinic, where he treats impoverished patients. Along the way, he stopped at a gas station to fill his tank. But as he reached for the pump nozzle, an employee ran out and suddenly grabbed his hand. "He told me, 'I'll fill it for you -- just go inside the station and wait for me to get done,'" Haddawi recalls.

Though a bit puzzled by the unusually attentive service, Haddawi gladly complied. A few moments later, the man joined Haddawi inside the station and explained why he had gone to such lengths.

"He said, 'You don't know me, but two years ago, my 5-year-old grandson broke his elbow on a slide and you came in to take care of him. We asked you if we could pay you five dollars a month because that was all we could afford. You told us to forget about it because it was free. But I could never forget that. So when I saw you again, I figured that the least I could do to pay you back was to save you five minutes of standing out there in the ice.'"

Such moving gestures from patients' families are only a small part of the personal reward that the 67-year-old Haddawi has garnered from working at the free medical center he helped found in 2007. "The volunteer doctors get a lot more out of it than what we deliver to the patients," he says. "When you work for pay, you're exhausted, tired out by it. When you take that out of the equation and you're freed to just focus on helping people, it's energizing. At the end of the day, you leave feeling better than when you walked in."

The Monroe County clinic is part of a growing philanthropic effort by mid career and retired doctors to provide free care for Americans who don't have health insurance. Volunteers in Medicine (VIM), which started two decades ago with a single clinic in South Carolina, now has 77 clinics across the nation. In the wake of the economic downturn, the services of volunteer doctors are in greater demand than ever.

Joining the organization's growing ranks of volunteer caregivers affords veteran doctors such as Haddawi, who retired in 2005 after practicing for 35 years, a chance to do more than simply repurpose their medical skills. By creating their own free medical clinics from scratch, they reinvent themselves as social entrepreneurs -- business-minded, results-oriented do-gooders who apply acumen and ingenuity learned in the marketplace to attack the underlying disease of poverty.

"We really don't have to wait for government to solve the problems for us," says Dr. Gene Cheslock, a retired oncologist who founded the VIM-affiliated Parker Family Health Center in Red Bank, N.J.

From Hilton Head And Golf -- A Clinic Is Born

Volunteers in Medicine was the brainchild of Jack McConnell, a physician, scientist and business executive for Johnson & Johnson whose career achievements included the development of Tylenol tablets and the commercialization of the magnetic resonance imaging (MRI) scanners that are a mainstay of modern medicine. When McConnell retired to Hilton Head, S.C., in 1989, he planned to relax and play a lot of golf. But, as he recounted in his 2003 book, The Story of the Volunteers in Medicine Clinic, he discovered he had too much energy for a life of leisure. Beyond that, when he ventured outside his posh gated community, he was shocked by the rural poverty around him.

McConnell found that a third of the island's 10,000 residents had little or no access to health care. He had a brainstorm. The island had plenty of retired doctors, nurses and dentists, and McConnell persuaded some of them to donate their services. He successfully lobbied the state to waive licensing fees and provide malpractice insurance coverage for his volunteers. (Eventually, in part due to McConnell's efforts, Congress also passed a law giving medical volunteers protection against malpractice lawsuits.)

The success of the Hilton Head clinic has inspired altruistic-minded physicians in other parts of the country. Today, VIM, whose national organization is based in Burlington, Vt., boasts clinics in 25 states, from Alabama to Wyoming. In 2008, 10,000 volunteers handled more than 300,000 office visits, and the need for their services continues to grow. "Our clinics have been swamped with suddenly unemployed, uninsured people," says executive director Amy Hamlin. "Some of them formerly were our contributors, and now they need help themselves."

The group provides a template and free consulting expertise to communities, but it's up to the locals to raise funding, lay the brick and mortar, and recruit volunteers to treat patients.

The dauntingly complex task of building a nonprofit clinic gives veteran doctors such as Haddawi a new challenge in life. A native of Iraq who came to the United States in the 1960s for his hospital training, Haddawi established a successful solo orthopedic practice in Bloomington. After retiring in 2005, Haddawi wasn't ready to spend all his time reading or at the gym. He went to a few meetings about volunteer medical missions in the developing world, but it occurred to him that people closer to home needed care, too. He found out about VIM and visited clinics in Indianapolis and Fort Wayne. "I thought to myself 'This is exactly what I had in mind,'" he recalls.

Perseverance Plus Bon Jovi Gala Pay Off

A few years earlier, Brooklyn native Gene Cheslock had felt rudderless as he wound down his 30-year hematology and oncology practice. While helping a local hospital raise money for a cancer center, he heard about a community group seeking better access to care for impoverished residents. Cheslock, who had provided free care to Vietnamese villagers as a military doctor in the 1960s, found himself holding organizational meetings in a local soup kitchen.

In 2000, Cheslock opened the Parker clinic in Red Bank, N.J. -- named after a father-and-son pair of local physicians, Dr. James W. Parker Sr. and Jr., known for treating patients regardless of their ability to pay. The clinic's first home was a spartan trailer donated by a local builder. Not everyone in town cheered Cheslock's efforts. "Some thought we were going to attract poor people and illegal immigrants to move into Red Bank," he recalls. "Others thought the trailer was an eyesore. There was one town council member who said, 'When this fails, just hook up the trailer, and you're history.'"

But Cheslock and his fellow volunteers persevered. In 2004, they moved into a new building with the help of $500,000 from a fundraising gala thrown by rock musician Jon Bon Jovi and his wife Dorothea. Today, the clinic's 60 to 70 volunteer physicians handle about 12,000 patient visits a year, free of charge. As the 70-year-old doctor proudly notes, that means 12,000 fewer visits to the overtaxed hospital emergency rooms that the poor often turn to as a last resort. He estimates that VIM is saving the hospitals and taxpayers about $3 million per year. Patients who visit VIM clinics often have multiple health problems exacerbated not just by a longtime lack of medical care, but also by poor diet, stress and the other rigors of poverty. The challenge of treating such difficult cases has compelled the volunteers to adopt a more holistic approach to care than is usually seen in for-profit, insurance-subsidized medicine. "Within our walls, we actually have 12 different clinics," Haddawi explains. "If somebody comes to the orthopedic clinic with bad knees, I may find that they have kidney problems or high blood pressure, as well. I send them over to the weight-reduction program that we have, or to psychological counseling. We even have an acupuncture clinic. It's all done by volunteers, under one roof."

To compensate for limited access to high-end technology and outside specialists, VIM also emphasizes conservative, preventative medicine. Cheslock's Red Bank clinic, for example, has a diabetes management program that helps 300 patients control their chronic illness and avoid crises that would necessitate emergency-room visits. He now has ambitions of adding a dental clinic. "When you're treating a patient in this model, you start to see that dental care has an impact upon diabetes management," Cheslock says. "You begin putting all the pieces together."

More Time To "Read And Exercise And Still Be A Doctor"

Being a volunteer also gives doctors an opportunity to try new roles, and to achieve a balance between their professional passions and other interests. After a stint as the Monroe County clinic's chairman, Haddawi now focuses on treating patients as a volunteer clinician, a role that allows him to divide his time between Bloomington and his retirement home in California. "I've got more time to read and exercise, and still be a doctor," he says. Cheslock, in contrast, has relished the opportunity to step away from his draining, narrow-focus grind of treating cancer patients and evolve into what he jokingly calls a "volunteer businessman." And he still manages to garden and golf.

"This has a whole different set of satisfactions than my medical practice," Cheslock says. "That was all one-on-one. This gives me the ability to affect thousands of people by providing an environment in which they can get the care they need. I really enjoy it."

Facts about Volunteers in Medicine

• As of January 2010, there are 77 VIM clinics across the nation.

• With 12 VIM clinics, North Carolina currently has more than any other state.

• By 2008, VIM clinics across the nation treated 100,000 patients, providing care on an average of three occasions for each.

• Establishing a VIM clinic generally takes one to two years of preliminary work.

• McNeil Consumer & Specialty Pharmaceuticals, maker of Tylenol, provides financial support for VIM's headquarters in Burlington, Vt.

• Visit VIM online at www.volunteersinmedicine.org.