I heard from a family medicine physician recently who explained she just retired after a long career.
Congratulations.
She had not quite figured out how she planned to spend her free time. But…
She had a long-standing relationship with a local marching band that trains locally. It performs both locally and on the road.
She’d take care of a collection of ailments, none life-threatening. She wanted to continue this relationship.
Since she’s a volunteer, she’s never been paid. She has never submitted a bill for reimbursement. She had been led to believe that if she performs services pro bono, she’s covered by Good Samaritan laws. She was dotting her i’s and crossing her t’s.
She looked into purchasing a bare-bones med mal policy, and she was quoted $5k/year. More than she wanted to spend for the benefit of volunteering.
I hated to be the one “pointing out the turd in the punchbowl.” But I was.
I do not believe Good Samaritan laws would protect her. Here’s why.
Good Samaritan laws are on the books to remove disincentives for the general public (or even those trained professionals) from stepping up and rendering assistance during an urgent or emergent matter. To qualify, the underlying condition being addressed must be urgent or emergent. You cannot be paid for the service. And the care must not be grossly negligent. Gross negligence is even more egregious than ordinary negligence. (There are other qualifiers, such as no pre-existing relationship, such as being on the call schedule for the ER).
My point is this. While not sending a bill is necessary, it is not sufficient.
Good Samaritan laws were implemented to deal with “one-off” situations. Not regular occurrences.
Merely not sending a bill is not a “Get-Out-of-Jail-Free” card. For example, if you provide a prescription to your brother-in-law, you likely would not charge him. You should, of course, document the rationale for the prescription and treat the case formally. But the non-sending of a bill will not, in and of itself, prevent him from later filing a lawsuit alleging negligent care.
Your brother-in-law may love you today. But maybe not later. And he could sue you.
What can a retired physician do, then?
There are options.
(a) One can volunteer at a free clinic (federally qualified health center – FQHC). Staff are treated as federal healthcare employees and provided federal malpractice protection under the Federal Tort Claims Act (FTCA). If someone has a beef with you, they’d sue the federal government under FTCA, not you. This is similar to you working for Indian Health Services, the VA, or military. You’re not directly in the crosshairs.
(b) There are also state-based free clinics. In Illinois, for example, for a retired physician regularly volunteering, the key is Section 30 – Free medical clinic; exemption from civil liability for services performed without compensation. (745 ILCS 49/30)
§ 30 says that a person licensed under the Medical Practice Act (or equivalent out-of-state license) who:
In good faith provides medical treatment, diagnosis, or advice
As part of the services of an established “free medical clinic” that:Provides care to medically indigent patients,
Provides only care that does not require a licensed hospital or ambulatory surgical treatment center,
Receives no fee or compensation from that source (the clinic),
“shall not be liable for civil damages” for that care, except for willful or wanton misconduct.
The statute also defines “free medical clinic,” which typically includes:
An organized clinic (often, but not necessarily, 501(c)(3)) providing care without charge to individuals unable to pay, and
A rule that any voluntary contributions can only be used for overhead, not to pay clinicians.
Finally, the free medical clinic must post in a conspicuous place on its premises an explanation of the exemption from civil liability provided herein.
Would this apply to taking care of the marching band? I doubt it. Among other things, the marchers are probably not indigent, as understood by the law.
Not all states have this carveout of immunity for free clinics. So, check your state before diving in.
(c) One can ask a local institution, such as a hospital, to deputize you as an employee for a limited role, such as caring for this marching band. If so, you’d ask for bundled med mal coverage. This process may come with baggage. You’d technically be an employee. Would you need to maintain privileges, etc? Possibly.
(d) Shop coverage. A good med mal broker should be able to find something less expensive. Here, the number of patients being seen is minimal. The activities being addressed are low risk. The overall risk should be low.
Finally, remember, even if you ARE covered by a Good Samaritan law, that’s an affirmative defense you’d make after being sued. That defense would be made by a lawyer. One you’d have to pay. So, be cautious about going bare.
What do you think?
