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Thomas Starr
Ben Henderson
CAS 138
13 April 2018

Implementing the Volunteer Healthcare Services Act into PA Law

Intro

Stan Brock was living with the Wapishana Indians in Guyana, South America, when the idea

of Remote Area Medical (or RAM) popped into his mind. Having suffered a minor injury while

there, he soon started to realize how many of the people around him were dying from things that

could have been easily treated in any first world hospitals. Because the closest hospital to him

was a 26 day journey away, many of those he was living with would never be able to get

treatment for even the most basic medical needs. After he left Guyana, Brock made it his own

personal goal to tackle this problem head on. Years later, Brock founded RAM in 1985. Since

then, RAM has been providing free medical services to inaccessible areas throughout the world

(ramusa.org, 2018). However, RAM does not just serve the inaccessible areas of third world

countries, but actually aim to serve inaccessible areas of the United States. By creating what are

known as temporary “mobile medical clinics,” RAM has been able to serve thousands in states

such as Texas, Virginia, West Virginia, Ohio, Louisiana, Oklahoma, New Mexico, Tennessee,

and Florida. With the help of volunteers and doctors from the community, as well as from

surrounding states, these clinics have been very successful in providing medical services to those

who may not normally have access to or be able to afford them (ramusa.org, 2018).
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The Problem

Despite the number of states that RAM already serves, Pennsylvania is simply inaccessible

due to some legislative hurdles. In fact, there are plenty of doctors from surrounding states who

are willing to volunteer, but due to the legislative complications, much more time and money is

required of these doctors to do so. This becomes a problem for RAM because as mentioned in an

article written by John Ross, a reporter who interviewed Stan Brock, some RAM clinics gain

60% of their doctor volunteers from the surrounding states (Ross, 2013). If there were enough

doctors in Pennsylvanian alone, this may not be an issue, but as explained by the Hospital and

Healthsystem Association of Pennsylvania, due to Pennsylvania’s very rural and geographic

barriers, there are “significant health professional shortages” (The Hospital and Healthsystem

Association of Pennsylvania, 2017). As a result, providing services through the mobile medical

clinics becomes a much more complicated process. As it currently stands, in order to obtain a

Pennsylvania medical license, one must not only pass the Pennsylvania Board Exam, but must

also go through an application process that may take up to 2-3 months to complete (Medical

Licensure Group, 2016). Having to go through procedures like this make it very difficult for

organizations like RAM to recruit volunteer doctors outside of Pennsylvania.

Solution

With the current policies that are enforced in Pennsylvania, it seems that being able to run

one of RAM’s mobile medical clinics in the inaccessible areas of the state may be impossible.

The current insurance and liability laws also add a lot of strain on the out-of-state doctors who

may wish to volunteer. However, if more specific policies are implemented, those who are most

vulnerable in our society can receive the care they so desperately need. In fact, Tennessee once
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faced the very same issue and has since then resolved it by passing what is known as the

“Volunteer Healthcare Services Act.” As described by Attorney Jason A. Lee:

[The act] ​provides a certain level of immunity for volunteer physicians who provide

healthcare in compliance with this statute.​ ​Specifically, healthcare providers

including physicians, surgeons, dentists, nurses, optometrists or ‘other

practitioners of the healthcare discipline’ who perform work for a ‘sponsoring

organization’ on a volunteer basis can be protected by the immunity provisions in

this statute.

Lee goes on to describe how the bill also protects doctors from being liable for “Civic

Damage” granted that is was not committed with “gross negligence or willful misconduct” (Lee,

2014). If a similar policy is implemented in Pennsylvania, then out-of-state doctors would easily

be able to volunteer in services like RAM, but would also still be required to go through the

normal licensing process in order to open a practice or make a living within the state.

No Other Major Changes Needed

The benefits that come with implementing a policy like Tennessee's “Volunteer Healthcare

Services Act” is that it would not require a mass amount of changes to policies already in place

within Pennsylvania's “medical licensing world”. To elaborate, this bill targets a very specific

situation and may almost be considered an official exception to the current Pennsylvanian

policies. This “specific situation” is actually outlined within the bill itself and clarifies that

doctors with out-of-state licenses may only provide their services at free clinics (Lee, 2014). The

bill goes even further by outlining that a “free clinic” qualifies as ​“a not for profit, out-patient,

non-hospital facility in which a health care provider engages in the voluntary provision of health
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care services to patients without charge to the recipient or a third party” (Lee, 2014). With that

said, it actually seems it would be fairly simple to implement a bill like this into Pennsylvania's

legislature. The bill itself would only be affecting a very small percentage of actual licensing

cases. And despite affecting only a small number of these licensing cases, passing this policy

would help hundreds of underserved patients across Pennsylvania’s most underserved regions.

Free RAM Clinics for Those Who Need it

In addition to being very feasible to implement, any obstacles that may arise from trying to

implement this change would be worth it compared to the benefits it would provide. As Stan

Brock has said, “RAM is the way that I have kept my promise” (ramusa.org, 2018). With the

implementation of this bill, his promise to provide basic medical services to those in need will be

extended to those living in Pennsylvania. And for as long as RAM has been operating, being able

to utilize the services they provide is something that is extremely valuable to the people who

need it. As described in an article by Ariel Leve, many of the patients that showed up at a clinic

in Tennessee waited in line for hours so that they would be sure to get a ticket to enter. In fact,

many even sleep overnight in their cars because of how important is it for them to be served.

Sometimes patients even have to be turned away because there is just not enough time in the day

to serve all that show up (Leve, 2016). Therefore, it seems the underserved people in PA will

certainly benefit from this bill like everyone else does in other states. Unfortunately, none of

these services will be available in Pennsylvania if a bill similar to the “Volunteer Healthcare

Services Act” is not passed and implemented.

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Travel is no Longer an Issue

While being able to get the free medical services that RAM provides, having this policy

passed will also cut down on the amount of travel needed to reach these clinics. One of RAM’s

main goals is to provide free and quality medical services, but in order to reach these

communities in need, it’s very important that the people in these communities are able to reach

the actual clinic to get these services. Yes, there are currently RAM clinics serving communities

in states surrounding Pennsylvania, but in many cases, going to these would take days of

planning. Patients may even have to book rooms in hotels or motels, which may not be an option

to some families due to money restrictions. What use would the free clinic be if no one could

afford the time or money necessary to reach it? Fortunately, if Pennsylvania had something like

Tennessee's own Volunteer Healthcare Services Act, the amount of doctors necessary to run a

clinic would be met, and these clinics could be run right in the Pennsylvanian communities that

need them most.

Disaster Relief

Another benefit that comes from having a policy like the Volunteer Healthcare Services Act,

is that in the cases of natural disasters, it may allow out-of-state doctors to help much sooner in

Pennsylvania than the current policy allows. According to a survey and report conducted by Lori

Boyajian-O’Neill (DO), Lindsey Gronewold (MS), and Alan Glaros (PhD), ​under the context

that a natural disaster has occured in Pennsylvania out-of-state doctors can go through an

accelerated licensing process (Boyajian-O’Neil, 2008). As mentioned prior though, with a policy

such as the Volunteer Healthcare Services Act, this even shortened process could be by-passed

completely, allowing doctors to provide their services as soon as they possibly can.
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Those Against the Policy

Despite the number of benefits that come with a policy like this, there may be some groups or

organizations that would be against it. As explained by Michael Ollove, a writer for The Pew

Charitable Trusts, the reason many states do not allow reciprocal license (which are similar to

driver's license in that they are valid no matter what state your in) is because each state likes

being able to create their own regulations for this process (Ollove, 2015). In Pennsylvania

specifically, detractors for a Volunteer Healthcare Services Act may come from the people and

or organizations that set the qualifications (and therefore the fees) for gaining a license to

practice medicine within the state. By adopting a policy like this, they may feel their means to

revenue may be attacked. Understandably, this is a valid reason why these organizations may

fear the new policy. However, when considering what percentage of revenue would be lost from

this, there may not be a significant loss at all. Since free clinics, like RAM, only operate once or

twice a year in a particular state, the amount of times that out-of-state doctors would be

bypassing Pennsylvania’s license fees would be very minimal. Additionally, if RAM is a main

reason these out-of-state doctors would be crossing the state lines in the first place, then it is

unlikely that the licensing organizations would notice any significant change in their revenue at

all.

Closing

In conclusion, a policy like Tennessee’s Volunteer Healthcare Services Act should most

certainly be implemented in Pennsylvania. With this policy, organizations like RAM would be

able to recruit the amount of out-of-state doctors needed to run a free clinic. These clinics would

go on to serve basic medical needs to the underserved rural areas of Pennsylvania, and would be
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a great value to the patients who have those needs. This policy would not require a large number

of current laws to be changed due to how specific of an area and context it affects. In addition to

all this, allowing out-of-state doctors to volunteer freely in Pennsylvania would not be straining

any of the current organizations in the state that make their money off of the normal licensing

procedures. Once this policy is in place, I believe thousands of underserved people will be able

to finally have access to and afford medical attention they need, and will continue to utilize these

services for years to come.

Word Count: 1852

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Works Cited

Boyajian-O’Neill LA, Gronewold LM, Glaros AG, Elmore AM. Physician Licensure

During Disasters: A National Survey of State Medical Boards. Retrieved April 2, 2018

from https://jamanetwork.com/journals/jama/fullarticle/1149358

Lee, J. (2014, August 10). Volunteer Doctors who Provide Free Services Under the

Volunteer Healthcare Services Act are Not Liable for Medical Malpractice

Negligence in Tennessee. Retrieved April 2, 2018, from

http://www.tennesseedefenselitigation.com/BlogEntry.aspx?id=171

Leve, A. (2016). Saint Stan Brock: Who Are You? Retrieved April 3, 2018, from

http://www.ariel-leve.com/all-articles/sunday-times-magazine/features/saint-stan-

brock-who-are-you/

Medical Licensure Group. (2016). Pennsylvania Medical License. Retrieved April

3, 2018, from https://www.medicallicensuregroup.com/states/pennsylvania-medical-

license.shtml

Ollove, M. (2011, December 15). Make Doctor’s Licenses Like Driver’s Licenses?

Medical Groups Say No. Retrieved April 2, 2018, from http://www.pewtrusts.org/en/rese

arch-and-analysis/blogs/stateline/2015/12/11/make-doct

ors-licenses-like-drivers-licenses-medical-groups-say-no

Ramusa.org. (2018). About RAM. Retrieved April 2, 2018, from ​https://www.ramusa​.org/

about/
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Ross, J. (2013, September 13). Missouri Lawmakers Relax Volunteers’ Medical

Malpractice Liability. Retrieved April 2, 2018, from

http://www.aaem.org/UserFiles/Jan-Feb14MOLawmakers.pdf

The Hospital and Healthsystem Association of Pennsylvania (2017, April). Critical

Access Hospitals: Key To Rural Health Care. Retrieved April 2, 2018, from

https://www.haponline.org/Portals/0/docs/Reports-FactSheets/Critical-Access-Ho

spitals-Key-to-Rural-Health-Care-April2017.pdf?ver=2017-05-23-084551-487