Managing to Care

By John F. Lauerman / May / June 2000
October 19th, 2007
Given the cost-cutting pressure doctors are under these days, you’d think they’d be unlikely to give medical care away. But thanks to a national program directed by H. Denman Scott, the Brown medical school’s dean for primary care, more than 11,000 physicians have volunteered to do exactly that.

Begun in 1993 with a five-year, $12 million grant from the Robert Wood Johnson Foundation, the program, called Reach Out, showed that many doctors are willing to donate their time to treat the uninsured if such questions as where and how are resolved ahead of time. Until its funding expired two years ago, Reach Out supported thirty-nine physician-volunteer programs across the country, including, for example, a free San Francisco surgical clinic where volunteer surgeons worked in donated operating rooms on Saturday mornings.

"It shows that the volunteer spirit is alive and well among physicians," says Scott, who notes that Reach Out physicians treated almost 200,000 patients excluded from the current health-care system. Clinical Teaching Associate Johanna Bell, Reach Out’s deputy director, says that about two-thirds of the program’s efforts have become self-sustaining. Scott has now founded Volunteers in Health Care, a similar effort also funded by the Robert Wood Johnson Foundation, to expand the approach.

Scott’s leadership in both efforts represents something of a conversion. Long an advocate of providing health care to America’s underserved, he worked with the Clinton administration on its ill-fated health-care reform proposal. Disappointed and somewhat disillusioned by that failure, Scott was skeptical when first approached about the Reach Out program.

"I was afraid it would be a lot of talk and little action," he says, "but I said, ‘Here’s a chance to put some projects in place with credible leadership and support.’ " Scott now estimates that if such programs could support 1,000 community efforts, about 5 million underinsured and underserved people could finally get the health care they need.

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May / June 2000