Health & Family

Volunteer doctors offer care with dignity for Meck’s uninsured

Dr. Tricia Rodney finishes fitting a partial denture for Hanmanth Nippani, who receives free care through Physicians Reach Out.
Dr. Tricia Rodney finishes fitting a partial denture for Hanmanth Nippani, who receives free care through Physicians Reach Out. rlahser@charlotteobserver.com

For the poor and uninsured in Mecklenburg County, there’s an alternative to charity clinics that feels a lot like having coverage.

Physicians Reach Out, a program of the nonprofit Care Ring, matches volunteer doctors and dentists with patients who can’t afford care. Patients who meet the income requirements get a card that provides them with ongoing treatment in doctors’ offices, with small co-pays.

“They get to really know you and they get to know your body,” said Calvino Hardin of Charlotte, who gets weekly treatment for kidney disease. “It breaks a lot of the anxiety that you feel.”

The program, created by the Mecklenburg Medical Society a decade ago, is going strong even as the Affordable Care Act has increased the number of people with insurance.

3,400 patients served last year

1,600 health professionals participating

$13 million in free care last year

That’s mostly because North Carolina lawmakers declined to expand Medicaid to the poorest able-bodied adults. The Medicaid gap means most people whose income falls below the federal poverty level – $11,670 for an individual or $23,850 for a family of four – can’t get government coverage or federal subsidies to help them buy private insurance. Physicians Reach Out covers people up to double that level, although many of them are shifting to Affordable Care Act policies.

“Originally it was kind of for the working poor. Now it’s people that are really, really poor,” says Care Ring Executive Director Don Jonas. Patients include immigrants who aren’t eligible for government aid and people whose income is unpredictable, including young adults working low-wage jobs, Jonas said.

Hanmanth Rao Nippani, now 78, came to Mecklenburg County from India to live with his children several years ago. His teeth were so bad he was in constant pain and could barely eat. Physicians Reach Out sent him to Dr. Tricia Rodney at SmileCharlotte.

Rodney pulled an infected tooth, filled seven cavities and replaced a broken crown and made him partial dentures, writing off more than $6,700 worth of care. Rao said he’s grateful to Rodney and Care Ring for providing him treatment “which will enable me to eat food during my entire life.”

Rodney, a Care Ring board member, says many doctors and dentists give free care, but Physicians Reach Out makes it easy. Staffers there handle the financial screening and can help with issues such as transportation, which can make it tough for low-income people to keep their appointments.

And while many charity dental clinics take place off-site and after hours, Rodney said, Physicians Reach Out lets her help people in her own office, working them into her schedule like any other patient. “I’d rather be doing dentistry and making a difference,” she said, “than sitting in my office sipping coffee and browsing my email.”

Dr. Dan Murrey, an orthopedic surgeon who recruits physicians to work with Physicians Reach Out, says it protects doctors’ time and patients’ dignity. “If we all agree that folks need to be cared for regardless of insurance status, then the best way is to spread it among all the providers,” he said.

It’s a way of organizing the process so it’s a little more rational and less random.

Dr. Dan Murrey on the PRO approach to charity care

Physicians Reach Out leaders were relieved when a recent Supreme Court ruling kept the Affordable Care Act subsidies intact. The volunteer corps wouldn’t have been enough to handle a flood of new uninsured patients. They’re still working to recruit volunteers, especially medical and dental specialists, to reduce patient waiting time for new appointments.

Proponents of the program say there are benefits to society as well as clients. Because uninsured patients have doctors, they’re less likely to use emergency rooms for routine care, a high-cost approach that generally gets passed along to taxpayers and insurance companies when patients can’t pay.

And for people like Hardin, a sous chef at J. Sam’s restaurant in the SouthPark area, staying healthy means he can work. When he first went to an emergency room in 2009, he was so sick, “I thought I had a death sentence,” he recalls. His doctors have helped him regulate his blood pressure and pare down from 19 medications to five.

Hardin, 47, admits he neglected his health when he was younger and had insurance. “I wasn’t going to a doctor because I thought I was healthy,” he said. Now he’s eager to let others know there are alternatives to waiting until you get desperately ill.

“I try to tell people about the program,” he said.

Ann Doss Helms: 704-358-5033, @anndosshelms

How it works

  • Mecklenburg County residents who are uninsured and have an income of no more than 200 percent of the federal poverty level are eligible. They pay a $30 application fee and are screened by Physicians Reach Out staff.
  • If they meet the requirements, patients get a Physicians Reach Out card and are assigned to doctors near their home.
  • Patients must make co-payments (for instance, $50 for a diagnostic visit and $20 for an emergency room trip) and keep their appointments to stay in the program.
  • Details: www.careringnc.org/programs/physicians-reach-out/ or 704-375-0172.
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