Charity Care

[Old_Mil]

Now that I'm done practicing medicine for a paycheck, I've been wondering how I can use some of my skills to benefit humanity.

My interest would be in straight charity care, seeing and treating eligible people without charging them a dime.

You'd have to find a way to limit the number of people you saw before everyone in the planet beat a path to your door. I think this would start by opting out of CMS and not seeing medicare and medicaid patients. I also wouldn't see commercially insured patients. I think I would have to focus on people who were unemployed or the working poor who weren't covered through their jobs and for whom Obamacare was too expensive.

I'd also try and find a way to limit my practice to roughly the confines of urgent care medicine, so no following pregnancies or chronic strange pediatric cases.

Have any of you done anything of the sort, even on a part time basis in addition to your regular jobs?

Things I've found out so far:

- Some states offer no protection for providing charity care
- Some raise the standard from simple to gross negligence
- Some offer a form of sovereign immunity
- A few offer both a raised standard and a form of sovereign immunity
- Some require you to practice only as part of a government funded clinic or 501c3 organization, and only in areas that the Department of HHS classifies as an underserved area of need.

Obviously, trying to keep one's expenses down would be a major factor. Licensure, DEA renewals, CME are all expensive, even without factoring in overhead and malpractice insurance.

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[southerndoc]

Have you thought about giving your time to teaching paramedics?

Are you interested in overseas work or only domestic?

I certainly wouldn't volunteer my time without some protection from liability.

 

[Old_Mil]

Pretty much open at this point, just looking at alternatives. Overseas work would have to depend on a few things like a reasonable assurance that I could go to a place and do this without getting shot, held for ransom, etc...and I could take my dog with me.

 

[Saddleshoes]

A FQHC would love to have you on board.
FQHC's have lots of uninsured, working poor, unemployed, undocumented, etc. people needing care.
(The FQHC might force you to take a pay check however.)

 

[d2305]

I still want to go on a medical mission, maybe the Philippines. I looked at the Hope ship, but they didn't want me.

 

[WilcoWorld]

Work for a hospice agency?

 

[namethatsmell]

Congrats on being able to do this. Is there a med school near you? Some run clinics for the homeless/impoverished as a learning opp for med students. You'd get to teach and treat at the same time and the school may cover your med mal etc.

What's your non-clinical job that pays the bills?

 

[rokshana]

Now that I'm done practicing medicine for a paycheck, I've been wondering how I can use some of my skills to benefit humanity.

My interest would be in straight charity care, seeing and treating eligible people without charging them a dime.

You'd have to find a way to limit the number of people you saw before everyone in the planet beat a path to your door. I think this would start by opting out of CMS and not seeing medicare and medicaid patients. I also wouldn't see commercially insured patients. I think I would have to focus on people who were unemployed or the working poor who weren't covered through their jobs and for whom Obamacare was too expensive.

I'd also try and find a way to limit my practice to roughly the confines of urgent care medicine, so no following pregnancies or chronic strange pediatric cases.

Have any of you done anything of the sort, even on a part time basis in addition to your regular jobs?

Things I've found out so far:

- Some states offer no protection for providing charity care
- Some raise the standard from simple to gross negligence
- Some offer a form of sovereign immunity
- A few offer both a raised standard and a form of sovereign immunity
- Some require you to practice only as part of a government funded clinic or 501c3 organization, and only in areas that the Department of HHS classifies as an underserved area of need.

Obviously, trying to keep one's expenses down would be a major factor. Licensure, DEA renewals, CME are all expensive, even without factoring in overhead and malpractice insurance.

See if there is a free clinic or a med school that is nearby that does free clinic and volunteer there.

 

[Apollyon]

What's your non-clinical job that pays the bills?

I know, but he will never, ever tell you. In fact, my money is on him not coming back to this thread. If (and that's a big "if") he does, he won't say a word about it.

 

[Mount Asclepius]

If you work as an EP for >10 years at >$400K, saving and investing most of what you make, then you can FIRE and do whatever you want for free without any compensation.

 

[robellis]

I know, but he will never, ever tell you. In fact, my money is on him not coming back to this thread. If (and that's a big "if") he does, he won't say a word about it.

Why are you being so creepy about it..

 

[RustedFox]

Why are you being so creepy about it..

If you have to ask...

 

[Apollyon]

Why are you being so creepy about it..

Dude, I think I can guess why you are on a probationary status.

In case you don't get it (b/c, apparently, you don't), it's not mine to tell.

 

[bravotwozero]

Nothing wrong with being a lumberjack out in B.C….

 

[Fox800]

A FQHC would love to have you on board.
FQHC's have lots of uninsured, working poor, unemployed, undocumented, etc. people needing care.
(The FQHC might force you to take a pay check however.)

Except you have to be under the boot of some midlevel in an administrative position...yeah, no thanks. Never.

 

[Doctor Bob]

Nothing wrong with being a lumberjack out in B.C….

You can sleep all night and work all day. You can cut down trees, and eat your lunch. Then go to the lavatory. On Wednesdays you can go shopping and have buttered scones for tea

 

[namethatsmell]

Nothing wrong with being a lumberjack out in B.C….

You can sleep all night and work all day. You can cut down trees, and eat your lunch. Then go to the lavatory. On Wednesdays you can go shopping and have buttered scones for tea

I like BC and buttered scones. How competitive are lumberjack fellowships?

 

[Saddleshoes]

Except you have to be under the boot of some midlevel in an administrative position...yeah, no thanks. Never.

ONLY if you are motivated by the money. The OP was clear that he is at a point in his career were the money is no longer an issue.
----After I retired (the 1st time) I worked for a FQHC and was beyond the control of the admin people because if they fired me, it was way too expensive to replace me. (As a matter of fact I rather enjoyed twinking the nose of the administration at that place.)

 

[Birdstrike]

When I fully retire from Medicine, which be at least 10 (likely closer to 15) more years, I don't think I'm going to do any patient care, at all. I might do some charity work, like habitat for humanity like my Dad, who's a retired medical guy, does. But provide Medical care? I don't know. By then, it'll have been a solid 30-40 years of that. And to be doing it out of the goodness of your own heart and risk having someone take your free care and try to hit the lottery by suing, too? I don't know. Maybe I'm too jaded, from having to work with the public. But after 30-40 years of it, I'm not sure I'm going to have the stomach for too much more. Would I miss it when it was gone? I don't know. Lol.

The only exception would be overseas where I have immunity and where the conditions are so bad I can both be of help and be fully appreciated for it. It also depends how healthy I am at that time and how much money I've saved. Healthy + money opens a lot more doors in retirement as far as activities, travel and other living.

A lot could change. But right now, my 'vision' of full retirement would involve doing something new and interesting, not more of the same-old. Maybe by then I'll crave the familiar? I don't know.

Either way, congrats to @Old_Mil in being able to entertain such options in an immediate way.

 

[sah]

In California, the Medical Board has a link to volunteer positions. You might check your state’s board for same. Also, Public Health needs volunteer physicians for vaccination clinics and temporary shelters for homeless Covid patients.

 

[Sushirolls]

Lots of restrictions being placed on what the vision of charity care shall be, and for what's to be delivered.
Obamacare really took a lot of people out of the 'in between' zones. And those who do full into these days are usually temporary or even choosing to be there.

If you want to give back, consider doing your usual clinical work, but take a pay hit to reduce your productivity requirements. So this way you can set up a quality med student rotation. Some gap time between patients, allows quality one on one teaching. This is likely going to be a better way to give back. A quality rotation with students they won't ever forget.