For physicians considering involvement in free clinics, this guide will give you insight into how to handle scheduling issues, developing a mindset for volunteer work, and gaining the support of team members in your everyday practice.
John Miyano, MD, a hand and orthopedic surgeon with Washington state-based Seattle Hand Surgery Group, paused as he contemplated the question he’d been asked. He’d been discussing his volunteer work with the Mother Joseph Clinic at the Swedish Medical Center/Cherry Hill Campus in Seattle, and I asked him why it was important to volunteer his time at the free clinic. His response was personal.
“I feel that part of the commitment to practicing medicine is community service,” Miyano said. “I feel strongly about that. Even when I first started practicing, I was taking trauma call at our regional trauma center in an effort to provide community service to those in need. I did that for five years, and after that, I was looking for another venue.”
That venue was the Mother Joseph Clinic, originally an independent pilot project, but now in partnership with Project Access. The latter is a program that began in Asheville, North Carolina in 1996, and has since spread to more than 60 locations countrywide. It has helped open the door to physicians who want to give back to their community.
Miyano is the hand surgeon at the Mother Joseph Clinic. He set up his schedule so that he could spend the afternoons on the first and third Wednesdays of every month at the clinic, and reserved time to do the surgical cases that come out of the clinic on the other Wednesday afternoons. He says one of the keys to being able to balance his time between the clinic and his own practice is commitment.
“Once you decide to make the commitment to spend time at the clinic, it’s not that hard to schedule,” Miyano explains. “Once I looked at my personal schedule and realized I had some flexibility on Wednesday afternoons, I just blocked them off and committed that to community service time.”
That consistent schedule, he says, is very important to the clinic. “Having somebody who is there on a consistent basis, where you know when you can schedule patients, when you can schedule the followups, and month to month they’re always available, is so much easier than having a group of physicians coming in and out and occasionally lending a hand here and there.”
It’s also important to develop the right mindset for volunteer work, Miyano says. He explains that the patients who frequent the Mother Joseph Clinic are those who have come through the Swedish Hospital system, or through a variety of the low-income community clinics that have been authorized to refer patients. Some come through the emergency room, and others through family practice residency programs the hospital runs that address the healthcare needs of many indigent, low-income ethnic populations.
“The patient mix is very different from what I see in my private practice setting,” says Miyano. “Unfortunately, many people who don’t have health insurance, or who have state insurance like Medicaid, are people who have a lot of disorganization and chaos in their lives. They bring that with them to the clinic. You have to be prepared to see people who need a lot of assistance with other aspects of their lives.”
What goes around…
Miyano says the experience of volunteering at a free clinic has been extremely graifying. He treats patients who are often in desperate situations—medically, financially, or both. Being able to use his skills to impact someone both medically and financially, he says, is very rewarding. And there are professional benefits to his regular practice.
“Many of my medical colleagues know that I participate in this clinic, and I think they refer patients to me sort of as a reward for doing community service,” Miyano says. “There have been some writeups in the newspaper and business journals outlining what we do at the clinic, and I’ve had some patients say they saw the article, appreciate what I’m doing in the community, and came to see me because they wanted to support my practice.”
For physicians considering involvement in free clinics, support is a key element. Miyano says his partners at the Seattle Hand Surgery Group are very supportive of the volunteer work he does, and when they’re on call, they don’t mind taking calls from his clinic patients. In addition, his medical assistant often handles the paperwork that occasionally comes in from clinic patients as well.
“For people who typically practice in one setting, it does create a little bit of confusion to have two practice settings,” explains Miyano, who is in his sixth year at the clinic. “Often, my clinic patients will call me at my private office trying to get in touch with me, or to get some paperwork done, so there’s a little bit of a balancing act you have to perform to keep your practices separate and things running smoothly, and the cooperation from your private office to help smooth out the kinks.”