EyeWorld is the official news magazine of the American Society of Cataract & Refractive Surgery.
Issue link: https://digital.eyeworld.org/i/76185
14 EW NEWS & OPINION A novel continued from page 13 community service, with a support- ive membership and available facil- ity space for my retrofit into a clinic. The local corporate leaders and the county hospital have been support- ive with technical services, donated equipment, and financial support. Local citizens have stepped forward in unexpected high numbers to offer help, perform tasks, and participate in patient care. The medical commu- nity has stepped up in the same spirit as what inspired me to create this free clinic. I have had a dream about my The exterior of Free Clinic Newton Source: Jeffrey Liegner, M.D. One added enjoyable aspect of a free clinic is the ability to practice medicine beyond your specialty, using skills taught in internship and residency, caring for common ambu- latory problems and addressing vari- ous degrees of illness that because of one's specialty are not common care items. Even internists and family practitioners, who commonly refer out many specialist problems, can use their training and treat condi- tions in a free clinic that they might otherwise have deferred elsewhere. And finally, the free clinic is simply an expression of the same commitment to humanity that has taken me and many others overseas on surgical missions. Without leav- ing my local community, I can care for the abandoned and the poor like our fathers and their fathers did. One quickly sees how a local free clinic with its protection from mal- practice liability derived from the FTCA addresses an important and unburdening reason to provide local medical care. Dr. Chang: What have been your greatest challenges? Who provided the equipment? Dr. Liegner: Organizing a free clinic creates many challenges, including finding a location and seeking a suitable community part- ner (whether that be a church, a fraternal organization, a corporate sponsor, or a hospital). Also, making the necessary arrangements for facil- ity and staff requires a great deal of personal analysis. Surrounding your- self with people who see the same vision and can move the idea into reality is very important. Organizing the free clinic into a nonprofit cor- poration, filing for IRS recognition as a 501c3 charity, and applying to the federal government under FTCA to be "deemed" a federal free clinic is a slow administrative process. Recruiting doctors, nurses, and lay people to volunteer is incredibly easy, simply by talking it up in the community, at the hospital staff meetings, and sharing your plans with patients. There is an incredible pent up desire to give and to volun- teer, but many don't know where or how, and those with an interest in medicine have had little opportu- nity to experience volunteering. Equipment has been donated, some by me from my office or my retired equipment from the base- ment, and some from other practi- tioners with surplus tables, chairs, cabinets, and medical devices. Even the computers and Wi-Fi for the free cloud-based electronic medical records were donated. Volunteers and non-volunteers donate money to support the clinic operations, and no billing occurs. Patients identify themselves to the extent they want, no financial information is collected or scrutinized, and no insurance cards are taken. Since I have my own surgery center, my eye surgeries are performed there. In the future, other surgery centers will receive the same FTCA protections, and their charity in providing free surgical services will be invaluable. Of course, minor procedures and simple suturing of lacerations occur in the free clinic. Dr. Chang: What is your typical volunteer schedule with the clinic? Dr. Liegner: My ophthalmology and general medicine walk-in clinic is set for Thursday mornings before I begin my afternoon office practice at noon. This is a 3-hours-a-week clinic for me, while other doctors con- tribute similar 3-hour blocks either during the day or evenings. Staffing is by volunteers, people committed to a similar community-based healthcare model, including retired physicians (who don't have malprac- tice insurance), hospitalists (getting a break from inpatient care, seeking some ambulatory care setting), nurse volunteers, plus moms and teenagers (interested in a career in medicine). There are no appoint- ments, as patients come when the clinic is open and return as advised. When the clinic reaches capacity and any more will exceed the doctor's time in the clinic, unfortu- nately the next people must be turned away (as there are only so many minutes in a clinic day). Dr. Chang: What has been the response of your community? Dr. Liegner: The response from the community has been extraordinary. My partner for this free clinic is the local Moose Lodge #432, an interna- tional organization committed to meager start inside the back end of the Moose Lodge and have seen the new building that we will build, larger and cleaner and more suited to the task of free community healthcare with pastoral counseling, early intervention programs, and community-centered offerings. I believe the need in so many communities is great, and our community will get behind such a dream. Dr. Chang: What is the advantage of doing this at a different location, as opposed to providing this care through your own office? Dr. Liegner: One important reason for having this free clinic in a sepa- rate facility is the FTCA regulations that govern this type of facility. Since it is deemed a free clinic for federal protections, no monetary transactions can occur there—no billing, patient payments, or claims submissions. A separate facility clearly makes this a distinctly separate entity for this purpose and provides this very important federal protection. Dr. Chang: What advice would you give others who might be interested in doing something like this? Dr. Liegner: As other doctors con- sider this possibility, for so many im- portant and personal reasons, there are resources available to help guide the enthusiastic team of community physicians, nurses, and supportive citizens in forming a free clinic. Not only do I have many links at our clinic's website, www.freeclinic- newton.org, there is a supportive organization dedicated to creating more free clinics in America, ECHO Clinics (echoclinics.org), with a helpful publication, echoclinics.org/_upload/pdfs/ECHO _GUIDE_091510.pdf. EW Contact information Liegner: liegner@embarqmail.com July 2012