Is There A (Volunteer) Doctor In The House? Free Clinics And Volunteer Physician Referral Networks In The United States

Abstract

Although community health centers and public hospitals are the most visible safety-net providers, physicians in private practice are the main source of care for the uninsured and Medicaid enrollees. Yet the number of these physicians providing free care is declining, even as the need for their services increases. One promising strategy for halting the decline is to strengthen and increase volunteer health care programs: free clinics and physician-referral networks. This report reviews the state of these programs and suggests ways to improve them. Given the limits of volunteerism, the authors conclude that only national health insurance will solve the problem of the uninsured.

Volunteer Experiences at a Free Clinic in the United States: A Qualitative Study

“…Free clinics are all run differently and each has their own approach to the demographics that they serve. But since all free clinics serve underserved populations with limited social and financial resources, the challenges that free clinics face may be similar to each other [3].…”

“…Free clinics provide an array of medical services at little or no cost to low-income, uninsured individuals in the United States (US), and often rely heavily on volunteers to provide services to vulnerable populations [3,4]. However, free clinics often experience uncertainty in funding sources and need to consistently fundraise to keep services and programs active [3].…”

“…However, free clinics often experience uncertainty in funding sources and need to consistently fundraise to keep services and programs active [3]. While volunteers provide many services that free clinics offer, there are few studies on volunteers' experiences in this environment.…”

The Perceived Impact of the Patient Protection and Affordable Care Act on North Carolina's Free Clinics

“…Free clinic executive directors were generally knowledgeable about the highly publicized aspects of the ACA, including states' autonomy in opting in or out of Medicaid expansion, the tiered subsidies to purchase insurance on the HIEs, and the original expansion of Medicaid coverage. A free clinic's ability to operate is tied directly to volunteerism, especially of physicians (which is already declining), and the potential lack of knowledge about the ACA among volunteers and donors may have significant negative consequences for free clinics [12]. Donors who lack an understanding of the ACA and its limitations may erroneously assume that free clinics no longer need private financial resources in order to provide health care for the uninsured population.…”

“…The ACA could also lead to a misperception that all uninsured individuals are now insured and thus inadvertently reduce volunteerism and donations to free clinics [11]. Volunteerism by physicians and mid-level providers is generally declining and may be exacerbated by declining insurance reimbursements and rising operating costs in doctors' private practices [12,13]. Declining volunteerism, coupled with a misperception that volunteerism is not needed, could be a devastating loss to free clinics.…”