Family physicians volunteer vital medical services to underserved community | Health

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Family physicians volunteer vital medical services to underserved community
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Family physicians volunteer vital medical services to underserved community

 

Sovereign immunity offers better access to care, protection from liability

For the thousands of underinsured and underserved patients who visit clinics in cities throughout the state, family physicians are the frontline for medical treatment that they might not otherwise receive.

“It’s the family physicians who keep patients from disability and the clinics are certainly an alternative to emergency room visits,” said Dr. Sue Nussbaum, MD, MBA, Executive Director of We Care Jacksonville, a provider of specialty medical services for uninsured and underserved individuals in Duval County. 

Dr. Nussbaum continued, “It’s family physicians that refer patients for screenings for breast and colon cancer for example, and if the patient isn’t screened – if she waits or never has the opportunity – there will be an ER admission and further treatment in addition to tremendous pain and suffering. Time is really the key in treatment for the patient’s long-term wellness and ERs were never established to do that.”

What makes it possible for family physicians and other specialists to volunteer needed medical services is what’s known as sovereign immunity. According to Dr. Nussbaum, the state of Florida passed the Access to Care Act in 1992 that provided sovereign immunity or protection from liability to medical practitioners who volunteer their services and do not charge a fee. All participating physicians sign a contract with the state and must have an active and free medical license.

“There’s no specific obligation required so it’s not a commitment for a certain amount of service,” she said. “Volunteers can see patients in their own offices instead of working at a clinic. These volunteers offer the full spectrum of care to people who would otherwise be dropped along the way. The patient who qualifies [income levels are up to 200 percent of poverty level] does not have to pay for these services. It’s an amazing network of dedicated and very generous people.”

Carolyn McClanahan, MD, CFP, is a family physician who volunteers her medical services twice a month during the evening at the Sulzbacher Health Center, one of the We Care Jacksonville clinics.

“Sovereign immunity is what gives me the ability to volunteer without the need of carrying malpractice insurance,” Dr. McClanahan said. “Because I’m no longer in active practice, it makes it possible for me to volunteer and I hope that the state never takes it away.”

After several years in private and emergency room practice in Richmond, VA, Dr. McClanahan returned to Jacksonville to teach at the University of Florida College of Medicine, Shands Jacksonville and also worked in various emergency departments. She went back to school in 2000, changed careers to become a Certified Financial Planner, and next opened her own financial planning firm for physicians and other professionals.

“I started volunteering at the Sulzbacher Health Center in 2005 and I enjoy practicing medicine and serving these patients. The people that I treat are no longer homeless. Most have jobs and can’t come to the day clinic. I have fun with people and I think that when you’re working in a situation like this, it reminds you that people are in different situations than you. These people may not get this care anywhere else and if we didn’t provide medical care, they may be homeless again,” she said.

Most of the patients Dr. McClanahan treats are those with chronic conditions such as hypertension and diabetes. The clinic is part of a network of practices throughout the state participating in the Florida Academy of Family Physicians (FAFP) Foundation Diabetes Master Clinician Program that gives physicians an edge on treating diabetes.

 “I see a lot of the same patients and I think everybody should volunteer doing the work they love. At We Care Jacksonville, you can volunteer some of your ordinary care time to patients so that you can see them in your regular office and I know physicians that do it. There’s a paid nurse practitioner on the Wednesday evenings that I don’t work and it would really save money if someone else was volunteering in that spot –there’s a need for more physician volunteers.”

Dr. Suzanne Harrison, MD, FAAFP, is the Florida State University College of Medicine Education Director for the Family Medicine Department of Family Medicine and Rural Health. She’s also the founder and sole practitioner of a free clinic at Refuge House, a residential domestic violence center in Tallahassee.

“I treat women and children [about 200 patients a year] in the Free Clinic.  It offers a safe place to be seen onsite so they don’t have to worry about being found by their abusers,” Dr. Harrison said.

Dr. Harrison has always been interested in domestic violence issues and knew someone who was a domestic violence victim while she was in training. “It’s a real life changer for everyone who’s involved.  My interest has evolved since then, with additional experiences caring for survivors of abusive relationships,” she said.

After completing her family medicine residency at Valley Medical Center, an affiliate of the University of Washington Family Medicine Residency Network, she spent 10 years in Walla Walla, Washington practicing the full spectrum of family medicine, including obstetrics.

“I worked with survivors of domestic violence and child abuse, and did a lot of work with the schools during my years in private practice,” she said. “Shortly after I moved to Tallahassee in 2003, I established the free clinic at Refuge House to serve the women and children who had been displaced by domestic abuse.”

She continued, “The clinic is open one half-day per week, at a time when it best serves the needs of the residents.  There’s a lot of triage, some counseling, identification of resources, and filling prescriptions for residents who have to leave home without them -- really whatever they need.”

Dr. Harrison is covered under sovereign immunity but as an FSU faculty member, is also covered by the state. As a medical volunteer, she also sees patients through the We Care system in Tallahassee and served on the board for the We Care Access to Care committee.

“I believe very strongly that all patients should have access to care,” she said. “As physicians, it’s our obligation to serve the community, and our patients.”

 

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