How can surgeons help the underserved?

[wolferman]

Right now I'm thinking about going into a surgical residency after medical school. As such, I'm trying to learn about the different ways in which a surgeon can help underserved populations (either inner city or rural areas). Every time I hear about doctors helping these populations, the reference is usually in regard to primary care docs. But I'm sure that surgeons can help too. The only such program that I know about is Operation Smile, where reconstructive surgeons operate on cleft lip/pallate patients. I would guess that Doctors Without Borders also helps in this capacity, but would any of you be able to point me to any others? Thanks.

Wolferman

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[sunflower79]

some similar orgs:
Interplast
Seva international (I think they focus on eye surg)

sunflower79 🙂

 

[Street Philosopher]

Charity cases. Like at UCLA, the plastic surgeons and neurosurgeons separated the guatamalan siamese twins. Certain groups go to other countries and perform basic surgery... some perform simple but significant surgeries to restore vision, etc.

 

[tugo]

great topic...glad to see that there are students who really do care about helping people....

i volunteered w/ an organization called Healing the Children. i think they are a national organization w/ regional chapters. i was involved w/ the oregon/w. washington one. http://www.healingchildren.org/welcome.html

surgeons can definately contribute. i went to leipaja, latvia w/ healing the children. my role was that of a medical supply coordinator. we had a plastic surgeon, an ophthalmologist, two anesthesiologists, and one family practice physician and support nurses.

i was surprised that a plastic surgeon would be use on a humanitarian trip like this, but he did many types of operations on the children and had made these trips many times before.
some of the operations were on children who had severe burns from boiling water. they were particularly susceptible because of their rural cooking methods. some were to fix deformities from severe dog bites which was also common in that rural area. it was really cool to see a z-plasty give a child almost full range of motion in his arm when before all the scar tissue had his arm fixed in the bent position. the surgeon definately changed the lives of many of the latvian children.

there are many opportunities to help w/ this organization and i look forward to it as a physician myself. good luck, and pm me if i can provide any more info...

tugo

 

[trubluwolv]

sometimes it's just about being in the right place at the right time to hear about what surgeons are doing on an individual basis.

one of my bosses out here in New York is an orthopedic surgeon. once a year, he takes a 2 wk tour of Africa with another surgeon, med students, and a complete surgical team. they do charity cases, mostly on debilitating conditions of idiopathic scoliosis in children. After his two week "tour", he returns to Africa on various occassions during the year to follow-up with his patients and also to provide general medical consultations.

this year, he took his office manager along and she was absolutely flabergasted by the reception he was given when he arrived in Africa. he's just an amazing human being!

if you want more information about him or interested in working with him, you can PM me.

 

[loyen]

Right now I'm working at a free clinic and due to pretty good relations with the community and the physicians in the area, we have several surgeons who volunteer their services to us.
There's an ENT that does at least one surgery for us gratis every two weeks or so.
We have SEVERAL orthopedists that perform surgeries for us.
And we've even had 3 heart surgeries in the last year, all free of charge.

 

[bosco]

Just one of many examples...

http://www.operationsmile.org/

 

[ironey]

A friend of mine spent some time with a group of American doctors who set up temporary surgical units in remote areas of India. She said it was amazing - a 2-3 day surgical marathon.

There are so many programs out there who would love to have a volunteer surgeon - you just have to look a bit!

Cheers!

 

[kimm70]

Both my grandfather and uncle (plastic surgeons) volunteered their services through Interplast, which is based out of Stanford. The organization sends plastic surgeons all over the world (3rd world countries) performing operations on patients who often travel hundreds of miles over several days just to meet with the surgeons. They often perform operations on patients that have congenital conditions (ie, cleft palates, cleft lips, etc.) I believe the Operation Smile organization performs similar work.

 

[carrigallen]

Usually doctors serve underserved areas best (especially in the united states) as primary care physicians, because this is where the greatest need for medical treatment is within our country. However, some surgeons go on vacation to volunteer their services to spend overseas in developing nations. These physicians provide special skills and supplies which are normally inaccessible to these populations.

Even though the United states has a severe shortage of primary care physicians, I think it might be possible to locate your general surgical practice in an underserved area as well. Keep in mind your reimbursements would probably not be on par with fellow surgeons outside your region.

 

[HouseHead]

I read an article about a group that brought plastic surgeons over to war torn areas of Africa to remove military tatoos that carried strong partisan stigmas.

Surgeons can also help simply by accepting Medicaid!

 

[medicnas]

While I'm all for helping the rest of the world - I'd rather help my own first.

Why not devote a whole afternoon every week to doing pro-bono work at your practice? This is what I envision doing. If you're gonna be a surgeon then you'll make enough to absorb the cost of the equipment and disposable stuff. Also, consider asking your staff to volunteer that one afternoon (inc'l your OR nurses). If they know you're not getting paid they might not mind either.

Since there are sick people everywhere and poor people everywhere you shouldn't have to go far 🙂 Perhaps offering your skillz to a free clinic for an afternoon would work? I'm sure they need surgical consults for some of the patients.

 

[medicnas]

Originally posted by HouseHead
Surgeons can also help simply by accepting Medicaid!

Bad idea - 1) once you open that door you'll never close it 2) It's not even worth the time to submit stuff and bang your head with medicaid. You're better off not accepting any kind of *aid and just doing the work for free (including absorbing any of the associated costs). As long as somebody is paying you it's still a leash (even if it's 10 cents on the dollar from Medicaid).

 

[carrigallen]

Originally posted by medicnas
You're better off not accepting any kind of *aid and just doing the work for free (including absorbing any of the associated costs).

i think medicaid is better for patients than offering free charity care from 7-8 am every other Saturday. I believe free care is valuable, I also believe that this is not an excuse to ignore medicaid.

I don't think it's right for destitute people to be relegated to sporadic charity care based upon the altruism of one or two professionals. Rather, I believe we should support the federal programs which are already in place to help the needy and indigent population. However, I do believe free care has a valuable place in society.

Like a previous poster said, you don't need to fly to africa to help needy individuals.

 

[medicnas]

Originally posted by carrigallen
I don't think it's right for destitute people to be relegated to sporadic charity care based upon the altruism of one or two professionals. Rather, I believe we should support the federal programs which are already in place to help the needy and indigent population. However, I do believe free care has a valuable place in society.

Like a previous poster said, you don't need to fly to africa to help needy individuals.

Accepting Medicaid patients will quickly become a burden to your practice. Seriously, all of my parents' firm's clients have ran screaming from it (even those who at one time thought it was a good idea) and have moved to 1) doing charity work outside the country through various orgs or 2) doing free clinic / free days @ the office. Medicaid is horribly broken, doesn't recompense doctors in any worthwhile amount and ends up pushing substandard care onto the patients (by virtue of the fact that it so horribly pays doctors that all the good ones stop accepting it). Plus once you accept even a penny for your services you're widely casting open the door for malpractice and throwing asunder any compassion a jury/judge might have shown for any purely pro-bono work. Also, by embracing the medicaid system you are tacitly approving of it - and perpetuating it. Now, if the government could do something like medicare for the poor...heck, it'd be great. But medicaid is not the answer.

Sorry to hijack the thread Wolferman!

 

[amelie]

the hospital where i used to work...texas scottish rite hospital for children...is a pediatric orthopedic hospital run entirely on charitable contributions. all the surgical procedures, related medicines, outpatient care, etc. are free. the hospital serves children of texas, regardless of their ability to pay. www.tsrhc.org

 

[wolferman]

Thanks so much for your responses everybody!! I'm going to save a copy of this thread so that I can refer back to it from time to time. Great stuff indeed.

wolferman

 

[Iron Horse]

Great thread -- I worked for a medical relief org for several years that does both domestic and int'l work. Going overseas to help can be done fairly easily, as others have pointed out, by hooking up with either a relief org or a university. Just be sure to research the org/univ prior to joining the team. There's a great deal of difference from one to another, and you'll do yourself a favor to know as much as possible before you're in country.

For domestic work, one poster already mentioned free clinics. This is a terrific place to offer your services. I worked at a free clinic and while pcps were our normal clinic docs, we recruited specialists to see our patients when referrals were necessary. This included surgeons for both out patient and, to a lesser extent, in patient services.

It's great to see people willing to help those in need. Good luck.

 

[indiamacbean]

In addition to the great ideas mentioned above, I would remind everyone (surgeons and others) that Doctors Without Borders is always looking for volunteer health professionals. The neat thing about DWB and surgery (as well as anaesthesiology) is that you can volunteer for much shorter periods of time (I think down to even a couple of weeks) rather than the six month commitment that is generally required at DWB.
On another note, I would also recommend looking into Dr. Paul Farmer's organization Partner's In Health based out of Harvard. They do amazing amazing work around the world and in my opinion serve as a model for domestic and international health projects. Dr. Farmer is an MD/PhD with his PhD in Anthropology and he has written extensively and lucidly on the intersection of international development and public health around the world. Anyone looking to do international work should really check out some of his writing and the organizations web-page. cheers.

 

[bailey39]

Contrary to what many people think/say, there is a dire need for specialists/surgeons in rural areas. Where I live, there is ONE gastro practice for around 150-200 miles....and the waiting times (for them as well as surgeons, cardiologists, etc) are enormous. I have never had to wait to make a primary care/family practice appointment. I know of a lot of other "rural folk" who feel similarly, although I am sure these is a need for more primary care as well.

Also, you can look into working on a Reservation. I know of a few surgeons and quite a few specialists (neuro, ENT, ortho, GI) who do this. The neurologist at the IHS (Indian Health Services) in Shiprock, NM just left to take a faculty position at UCSF and the GI guy had been on faculty at Vandy...so there are amazing people to work with and you can offer so much to the area. Just a thought!! Oh, Columbia Med has a rotation there too!

Lastly, Paul Farmer/Jim Kim's Partners in Health Organization is truly incredible--and to think they started it as med students...pretty amazing. Good luck!

 

[PTjay]

You could work at a Shriner's Hospital which if I am not mistaken provides all care to children for no cost to the parents. I could be way off with this one but I believe that's how the Shrine works. That way you could get paid and still provide to almost entirely underserved patients. There's one in Mass. that is amazing.

-PTjay