Volunteering has been the hallmark of medicine and ophthalmology from our beginning. How many of you did volunteer work in clinics and hospitals during college and medical school? How many of you did surgical missions during residency and while in practice? How many times have you seen a patient for free or reduced his/her bill? Every one of us has done some form of volunteering.
We have all spent years in training and so many more years developing our knowledge and experience. The day you retire, that ability to care for patients doesn’t just evaporate. It’s still inside us. It is an honor to have learned the art and science of ophthalmology. It has been a privilege to have practiced and earned a living from our profession. We should have a desire to give something back to our communities and to patients who are unable to afford proper medical care.
We are not talking about major eye surgery, but the more routine aspects of our practices that make a difference in people’s lives: refractions, helping clinics obtain free or low-cost glasses, diagnosing and treating glaucoma, uveitis, amblyopia and more. We are all able to diagnose cataracts and diabetic retinopathy, screen children for strabismus and help find fully licensed ophthalmologists or clinics to provide the more advanced care.
Surgey room at Bonita Eye Clinic
Many will ask about the roadblocks, like maintaining your license after retirement and the big question of malpractice insurance. More and more states have been looking at these problems because they know volunteer physicians are a wonderful resource when it comes to the problem of medical care for the uninsured. The American Medical Association has been tracking the availability of limited licenses and malpractice costs for retired physicians, and their last update in 2016 showed that 37 states have special limited licenses for retired or volunteer physicians.
Resources to consider: The Federation of State Medical Boards, lists the states with limited licenses (see page 91), and you can find the addresses, telephone numbers and executive directors of each state Board of Medical Examiners.
There are many stories about ophthalmologists, not all retired, who have started free or reduced fee eye clinics. Philip Rizzuto, MD, for example, chair of the Communications Committee, started a volunteer eye clinic in Rhode Island. Placing sovereign immunity under the state’s Good Samaritan act solved the malpractice problem in Rhode Island.
Alfonse Cinotti, MD, former professor and chair of the department of ophthalmology at Rutgers Medical School, in Newark, New Jersey, now lives in Naples, Fla. He helped start a volunteer clinic providing eye care. The Naples Lions Club has been doing free eye screenings with volunteer ophthalmologists since 2006.
In 2012, the Bonita Springs Lions Club built a well-equipped free eye clinic where six retired ophthalmologists volunteer and serve people who were picked up at the screenings and who are within 200 percent of the poverty line.
Retired physicians must apply through the Florida Board of Medicine and have sovereign immunity through the state while working in these clinics. Interestingly, the fully licensed ophthalmologists who provide the surgical care are also under the same sovereign immunity.
Bruce Shields, MD, editor of Scope, started a free eye clinic in his hometown of Burlington, N.C., after his retirement. There are many private and faith-based free clinics and even a National Association of Free and Charitable Clinics, which you can find online by goggling volunteer health clinics.
Volunteer eye clinics desperately seek your talents. Years ago, hospitals had eye clinics which were manned by volunteer ophthalmologists. Unpaid ophthalmologists in private practice mostly staffed our residency training program clinics. The residents had role models for volunteering, and now full-time faculty has replaced the volunteers.
It is so important to have role models in volunteerism for our residents in training and young ophthalmologists. The volunteer ophthalmologists of today are getting older and need younger physicians to step in and help with the never-ending volume of patients in free clinics.
There are still states that do not have good laws allowing retired physicians to volunteer and protect them from malpractice claims. If your state does not have a law, you need to contact your state medical and ophthalmological societies and ask for their help in getting bills introduced.
If you haven’t experienced the personal rewards of having someone say, and really mean, “Thank you,” it may be time to volunteer. It is a perfect way to stimulate your mind by continuing working in the field of medicine you love.
Editor’s Note: Despite the Affordable Care Act and the expansion of Medicaid in some states, some patients still fall between the cracks and would not have access to quality eye care if not for free and charitable clinics.
Senior ophthalmologists who are still actively practicing should be aware that the American Academy of Ophthalmology’s EyeCare America program (firstname.lastname@example.org), which provides free eye exams by volunteer ophthalmologists, is still alive and well, but needs your participation.
The American Glaucoma Society (americanglaucomasociety.net) has also launched the AGS Cares program, which provides no cost surgical glaucoma care by its volunteer members, and your subspecialty may have similar programs.
Contributors; Alfonse A. Cinotti, MD, Philip R Rizzuto, MD
Special thanks for research help; Michael Levitt, Academy staff; Drew Carlson, Federation of State Medical Boards; and Kristin Schleiter, JD, AMA staff.