Fearless faith drives some Alabama physicians to toss their profit potential and risk volunteering a few hours a week, helping people who are least able to afford medical care.
They volunteer at free medical clinics where their malpractice insurance may not always cover their philanthropic practice of medicine. Nonetheless, these free clinics and the services they offer flourish — and not only in Alabama.
According to Evangelical Press news service, Fox News is reporting that the number of faith-based health clinics is on the rise in the United States. At least 150 of the centers are operating nationwide, according to the report.
“Every time we open the doors we have two to three family practice physicians [volunteering],” said Ken Adkisson, board president of M-POWER Ministries of Birmingham Baptist Association. He said the clinic, located in Birmingham, also has a dermatologist and a pediatrician offering free services.
Clinics across the state
Other free clinics across Alabama, such as Medical Outreach Ministries, Montgomery, have physician volunteers who are largely unaffected by malpractice insurance issues. There are eight doctors who volunteer at the clinic — among them are Baptists, said Dr. Victoria Beckman, emergency medicine, who is medical director of the clinic.
“I just don’t live a fearful life and that is the key,” said Beckman, who practices through Alabama Emergency Room Administrative Services at Baptist Medical Center East in Montgomery.
She said malpractice insurance concerns have affected the clinic’s ability to enlist specialists as volunteers for years.
“Our oath is clear, I’m not being Pollyanna about it, but it’s sad that we’ve gotten so concerned about malpractice,” she said. “We are going to push past that to take care of the patients.”
Patient care leads the priorities for The Great Physician Clinic (GPC) in Albertville, which is owned by Marshall Baptist Association.
Charles Woods, clinic director, said the association pays for malpractice coverage for nurses and dental hygienists and for liability coverage for general volunteers. Physicians must provide their own medical malpractice coverage. Most physicians’ coverage from their for-pay practice extends to their volunteer work, but for some, such as emergency room doctors, it does not, Woods noted.
Free medical and dental services at the GPC have helped more than 1,400 people since March 2002, Woods said. Currently, two physicians, 15 nurses, six dentists and 14 dental hygienists volunteer.
Protection for doctors who volunteer at free clinics hinges on the various state and federal laws.
Beckman and Adkisson claim their medical volunteers are covered under the Good Samaritan Law (GSL) of Alabama. The GSL was written to encourage physicians and other qualified people to help accident victims, said Jack Nelson, a professor specializing in malpractice insurance at Samford’s Cumberland School of Law.
Certain states have amended that law to include physicians at free clinics, Nelson noted. “There are not enough cases where the [GSL] law has been tested to its limits. A court could see it either way.”
Adkisson said most doctors he encounters believe they are protected under this law while others believe they could still be sued, even though their philanthropy is separate from their for-pay medical practice. “Many of our doctors have “no serious concern about [being sued].”
Legal protection
“We feel it’s [GSL] pretty strong here in Alabama and covers most situations,” said Dr. Tim Denton, internist and medical director of the M-Power clinic.
Denton, who has volunteered at the clinic since its beginning, explained that malpractice policies for working doctors extend to cover volunteer work, but it does not for retired physicians.
“It’s made it really hard for retired physicians to volunteer when they finish their practice,” he said. “They buy coverage that protects them against future claims from patients they’ve treated while working, but not from new patients they treat during retirement as a volunteer.”
Whether physicians are retired or working, they may be covered under another law — the Volunteer Protection Act (VPA), a federal law enacted in 1997. It protects physicians, but not the nonprofit organization, said Joseph Snoe, a Cumberland law professor.
The VPA protects physicians and other volunteers, but “a host of specified exceptions narrow its scope,” a Brooklyn Law Review article states. It cites several instances, among them gross negligence, willful misconduct or anything constituting a hate crime.
The best chance of being protected by the VPA comes by doing everything with moral integrity and with as much thoroughness as possible, Snoe said. “If you are protected by the law you can still be held liable. It appears that the charitable organization the doctor is volunteering for can be sued, whether the doctor is sued or not.”
Doctors Insurance Reciprocal (DIR), a company that insured 800 of Alabama’s approximately 9,500 practicing physicians, was declared insolvent and liquidated by Tennessee’s department of commerce and insurance in 2003, said Courtney Callis, a spokesperson for the Reciprocal Receiverships Administration Office, an independent Nashville firm handling the liquidation of DIR and other companies.
Insurance woes
“It really is becoming a problem for those physicians that are dropped or have their carrier stop writing insurance,” said Cary Kuhlmann, executive director of the Medical Association of the State of Alabama.
Once dropped, some insurance companies no longer write new malpractice policies on independent physicians, according to the American Medical Association (AMA).
These doctors must be part of a practice or group that has malpractice insurance to have their work covered.
The AMA has declared 20 states to be in a medical liability crisis. Alabama is not among them but it shows signs of becoming one, the AMA said.
The crisis states are characterized by a lack of adequate reforms, instigating further rises in premiums. States with reform bills to combat this often have a cap of between $250,000 to $350,000 on non-economic damages and a statute of limitations, according to the AMA.
Curtis Harris, a lawyer and professor at the Oklahoma College of Law, said many states are looking at reform.
“Short of legislative protection, [free] clinics have no solutions of their own,”
Harris said. “They have little legal counsel and they’re low-budget.”
“I would suggest inside the next three years, most states will have to re-look at their situation, and there will be some clinics in different states that just have to close,” Harris said.
Adkisson agrees, saying for most Christian nonprofit clinics carrying malpractice insurance is an option prohibited by cost.
“M-Power does not carry [medical malpractice] insurance. If we did we would have to close the doors,” Adkisson said.
(ABP contributed)
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