January 2009

A Simply Extraordinary Idea: Volunteers in Medicine Celebrates 15 Years

Author: Paul deVere

In a sense, it is like a fairy tale. Once upon a time (1993), on Hilton Head Island, there lived hundreds of retired doctors and dentists and nurses and other medial professionals. And once upon a time (1993), one out of three people who called the island home had little or no access to adequate health care. They were poor. They had low-paying jobs or maybe none at all.

The knight in shining armor who changed the lives of those one-in-three was a fellow by the name of Dr. Jack McConnell. His idea was simple enough: put together a volunteer staff of retired physicians and other health care professionals and offer free medical service to those who couldn’t afford it—those one-in-three.

It took McConnell and several volunteers, a few years to pull it all together before the Volunteers in Medicine (VIM) clinic could open its doors (1993). But by getting state laws regarding retired physicians changed (everyone said that was impossible), and getting malpractice insurance changed (impossible), McConnell made it possible for retired healthcare providers to do what they loved: help make people well. More importantly, these professionals and a cadre of lay volunteers were able to offer care, in 2008, to 11,000 active patients (31,000 patient visits annually) at no cost.

But, as McConnell will tell you, that first word in the name of the clinic on Hilton Head Island—“Volunteers”—is what has created one of the most spectacular advances in free medical care for those who never had it or couldn’t afford it.

“We have100 doctors that volunteer, 85 nurses, about 25 to 30 dentists, 15 mental health professionals, and about 250 lay volunteers. They are just tremendous,” said Dr. Frank Bowen, the clinic’s executive medical director.

“We’ve got all of our patients with chronic diseases, like hypertension, diabetes and asthma under disease management programs now. They are seen by doctors, nurses, educators, nutritionists, a whole team of people,” Bowen said. He said that by catching these chronic conditions in early stages, the intensive—and expensive—treatment required just to stabilize a person when the condition goes unchecked, doesn’t happen. “We have 425 diabetic patients we take care of. Our patients are not admitted to the hospital because they’re getting good care,” he explained.

Bowen said that the volunteers, who work part time, represent 22 medical specialties and two-thirds come from teaching hospitals. The clinic is a favorite for medical student rotation from MUSC (Medical University of South Carolina). “They love it,” Bowen said, “and the doctors love to teach.” The clinic was named the best teaching site by the South Carolina AHEC (Area Health Education Consortium) for 2008.

“One reason I retired here was because of the clinic,” said Dr. Ross MacKay, who volunteers three half days a week. His wife, Helen, volunteers as a lab technician. Though MacKay’s specialty had been orthopedic surgery, when he came to the clinic he had an option. “I said I’d like to do general medicine. They needed general medicine. I think I get as much out of this as the patients do. It’s really very rewarding. It’s amazing, sometimes a good hug from a lady means more to you than anything else,” he said.

“We manage everything we can, short of the ER. Since we have a lot of experience, to some extent, we can get by with less sophisticated tests. We can’t order an MRI on anybody who walks in the door. So we have to count on our experience, intuition if you will. We keep (our patients) out of the emergency room, and the hospital gives free laboratory care, which would be a huge expense,” McKay explained. Hilton Head Hospital is truly a fan of VIM. The clinic saves the hospital’s emergency room an estimated $16 million a year.

Of course a “free” clinic involves costs. The budget for 2009 is $1.7 million. “At $55 a patient visit, that adds up to real money,” Bowen said, referring to the average cost per visit. Due to the difficult economic times, budgets have had to be tightened.

“We’re cutting expenses where we can. We put out a call to our patients and asked who would volunteer to get on a team to clean the clinic. Forty-eight people said ‘yes’ in a week,” Bowen said, proudly. The team is trained to meet OSHA standards, and they are saving the clinic $26,000 a year. “And the place is cleaner than it’s ever been,” said Bowen.

The clinic is funded by grants, donations, bequests, events and organizations such as the Bargain Box, the Heritage Classic Foundation, and many others on the island. Getting that money is Margie Maxwell’s job. As director of development and public relations, she knows it will be a challenge. She left a high-paying job in the health insurance industry to come work for the clinic. “People roll their eyes when I say I love to write these grants. But I do. I know the story; there’s a lot of passion to it,” Maxwell said. “You know what? There isn’t a day I walk into this clinic that I don’t see tangible results of what I do.”

What she’s done is go “off island” to successfully solicit grants from companies like Blue Crosse Blue Shield of South Carolina, Merk, the Kohman Foundation and Avon Foundation. “Just those two provide $150 thousand,” Maxwell said. The two foundations, focused on fighting breast cancer, help provide funding for the 600 free mammograms the clinic performs every year.

“When you come to work every day, everybody else who is here with you wants to be here because they choose to be,” said, Stan Stolarcyk, director of volunteers. “It’s a working environment unlike any I’ve ever had—people who see the hands-on results of their volunteering for that day. They are having the opportunity to help somebody right then and there.”

Stolarcyk’s responsibilities include scheduling all nonprofessional volunteers based on the clinic’s daily needs. Included are anywhere from four to eight interpreters. About 47 percent of the clinic’s patients are Hispanic. “But it’s not just Spanish. We have interpreters who speak Eastern European languages, even Portuguese,” Stolarcyk said.

Among those volunteers are high skilled “screeners,” who qualify patients. The qualification includes those who are living at 200 percent or below Federal poverty guidelines, don’t have health insurance, and live or work on Hilton Head Island or Daufuskie Island. Over 70 percent of the patients have jobs; another 20 percent are students or children; and the remaining 10 percent are either unemployed or indigent.

Fifteen years ago, Dr. Jack McConnell was sure he had the right idea to help the island’s medically underserved. It was a new idea, something that hadn’t been tried. But McConnell had been there before. His résumé as physician and scientist includes helping develop the Tine test for TB, Tylenol, and the first commercial MRI scanner.

His idea was so “right,” VIM has gone national. There are now 71 VIM-modeled clinics in 22 states. When McConnell—just about everybody calls him “Dr. Jack”—is asked why he did it, he always refers to something his father, a preacher, said as the family (seven children) sat down to dinner. “And what have you done for someone today?” he would ask. Volunteers in Medicine became Jack McConnell’s answer.

For more information on how you can volunteer or donate to Volunteers in Medicine, visit www.vimclinic.org.

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