This winter, as the bulk of the Affordable Care Act goes into effect, there are still tens of millions of people in the U.S. without health insurance. Immigrants, the self-employed, temporary workers, and others can fall between the cracks of private plans and government programs. For these people, Volunteers in Medicine is a network of pro bono clinics that offers free, high-quality care.
The first VIM clinic was founded 20 years ago by Dr. Jack McConnell, a pediatrician and pharmaceutical researcher who helped develop Tylenol and MRI technology. He and his wife had retired to Hilton Head, South Carolina, where the seasonal tourist economy left one in three local residents periodically unemployed and uninsured. “It was not until I stopped saying, ‘Someone should look into this problem,’ and realized I was speaking to myself that it really turned around,” McConnell recently explained.
Retired doctors, nurses, and dentists came forward, eager to volunteer their skills. When word spread, and other communities expressed an interest in opening their own free clinics, McConnell set up a separate organization, the Volunteers in Medicine Institute, to help them navigate the process.
Under the institute’s executive director Amy Hamlin, the VIM Alliance has grown to 96 clinics and counting, staffed by more than 11,000 dedicated volunteers, in locations ranging from Farmville, Virginia, to Indio, California, to inner-city Baltimore. They offer their patients a full range of services, including dental work, mental health care, nutrition counseling, and referral to a nearby hospital when necessary. Much of the care is aimed at chronic conditions, in an effort to prevent these long-term afflictions from debilitating their victims.
Patients are treated free of charge, with perhaps a nominal fee to fill their prescriptions. Each clinic is independently managed and supported by grants and donations from the local community. Hamlin’s central office, with a lean staff of four and an annual budget of about $300,000, provides technical assistance for the whole network and works to get more clinics up and running across the nation.
Meanwhile, the original branch in Hilton Head, South Carolina, is going strong. It recently received an anonymous $40,000 donation to expand the pharmacy, which has seen a tenfold increase in the prescriptions it dispenses annually.
Looking back over the past two decades, Hamlin takes pride not only in the clinics they’ve helped start but in many more that were inspired by VIM without officially joining the network. “Hundreds of free clinics have come as a result of Jack McConnell’s vision,” she says. The American Medical Association Foundation named one of its annual leadership awards for him.
Like McConnell, many VIM staff are retired nurses and physicians who offer to serve their communities without pay after a full career. Others are active professionals who carve out a few days each month to volunteer. “It’s the kind of experience that motivates people to go into medicine in the first place,” Arthur Peisner, chairman of a clinic in Massachusetts, told the Berkshire Eagle. Individuals who were called to medicine by a strong desire to serve people, only to find the bureaucratic realities of practice dispiriting, often discover that the mission of VIM renews their sense of purpose. The volunteers and supporters “are just the most amazing people,” says Hamlin. “It’s very joyful work.”
While the free labor of thousands of medical professionals drives these facilities, donors cover building rents, lab charges, support staff, and medication costs. The end product is a half-million annual patient visits, all produced at a modest philanthropic outlay of $288 per patient (as of 2012), including all lab work and medicines, and the average cost per patient visit was $80. Various federal and state laws protect the volunteers from malpractice claims.
Because the clinics don’t take government funding, each has the flexibility to tailor its operations to the needs of the community, and they don’t stand or fall according to political priorities. “They were established from the get-go to be sustainable,” says Hamlin, who has been awarded the William E. Simon Social Entrepreneurship Award for “nonprofit leaders who have found innovative, private solutions for America’s most pressing social problems.”
“Safety-net clinics,” notes Hamlin, “are going to be needed for a very, very long time.”