Operating free clinics while running your traditional practice

December 18, 2009

In one such free clinic model, called Project Access, physicians donate appointment slots in their offices, allowing them to practice in familiar surroundings without the restrictions of free clinics.

Key Points

Shelli Cannon, MD, likes the familiarity of the free clinic where she volunteers. It has the same equipment, supplies, and procedures as her offices at Parkway Medical Group in Asheville, North Carolina. In fact, it has the same address.

Cannon, a family practitioner, is one of a growing number of physicians donating time and care through an improved model that lets them work out of their own offices and with their own staff. At a time when more people are losing their health insurance or postponing care they can't afford, the hope is that this network approach will make it easier for physicians to volunteer.

Instead of requiring physicians to leave their practices and drive to a free clinic, Project Access asks physicians to donate appointment slots in their offices, saving time and allowing them to practice in familiar surroundings without some of the restrictions of free clinics.

Cannon, who used to volunteer at a free clinic, says she likes no longer checking with a clinic pharmacy to see what is in stock before writing a prescription.

HOW IT WORKS

Project Access is a community-led collaboration of physicians, hospitals, and pharmacists to provide healthcare to the low-income uninsured. In other communities, free clinics have built similar networks.

Typically, each branch of Project Access determines the local eligibility criteria for the program. Administrators screen applicants and solicit local healthcare professionals for donated time and services. Project Access schedules the appointments according to the guidelines set by each practice. The program handles all the paperwork, including referrals to specialists and scheduling follow-up appointments.

It's easier for patients as well. They can avoid the stigma of visiting a free clinic and, in many cases, continue seeing their own primary care physicians. At Parkway Medical Group, for example, all clients are former patients referred to the program when they lost their health insurance, Cannon says.

About half of the 1,200 free clinics nationwide follow a similar model, says Nicole Lamoureux, executive director of the National Association of Free Clinics, in Alexandria, Virginia. The virtual networks are growing as healthcare communities search for solutions to the increasing uninsured and underinsured populations, she says.

"What we say is, when you see one free clinic, you've seen one free clinic," Lamoureux says. "That's because each free clinic is the community's response to the healthcare need in that area."

In some communities, Project Access and free clinics work together. This arrangement is particularly helpful in setting up appointments at hospitals or with specialists, which are an integral part of Project Access programs.