One of the biggest barriers to providing free care is the cost to actually provide free care. Staffing a free clinic, providing free meds, obtaining insurance coverage (general liability and malpractice) all add up. Someone pays somehow-whether financially or by donating time/resources.
In the free clinics I worked in, most providers donated their time, but someone still had to pay their malpractice insurance. Typically the clinic covers it, or if the clinic is associated with a medical school or residency program, then the attendings’ malpractice insurance likely already covers it.
Malpractice insurance is typically very specific. I am a sole proprietor-I need to tell my malpractice company (I have an individual policy) what duties I will be performing and where I will perform them. I can’t just start doing random joint injections and expect to be covered unless I ask to be covered for them, for example.
If I want to add free clinic work, then it is up to the underwriters to determine if there’s more risk to the insurance company, and if so, increase my premium accordingly. But if I donate my time without notifying them I am doing free clinic work, then my policy is not going to cover me for any lawsuits that may arise from that work.
It would be the same for an employed physician-unless expressly stated in your contract, you are only going to be covered for the duties you are specifically asked/required to perform in your contract. If you do stuff on the side (like moonlighting as a resident, volunteering at a free clinic, etc), then you will need to arrange for appropriate coverage.
