Monday, March 22, 2010

The Trouble With Giving Away Free Health Care

It all started with a question: "How much do patients value primary care?"

I was having an online discussion with other primary care physicians and this question came up. Someone suggested that one way to find out was to offer medical visits and have patients pay whatever they thought the visit was worth. Okay, I said, I'll give it a try. But when?

For the past few years, I kept intending to do something as part of Cover the Uninsured Week, but never could figure out what I could do. This year, I thought, I could make this experiment part of that. But when I checked the Cover the Uninsured website, there was no date set for their annual Cover the Uninsured Week. Maybe they weren't having one this year?

So I dragged my feet. Then on March 10th I checked the Cover the Uninsured website one more time and whoops! Cover the Uninsured Week was suddenly the next week! When did they decide that?

I had to make some quick decisions. I decided to have a one day event on March 23rd because that was during Spring Break; I wouldn't need to pick up my kids from school and I could stay all day at the office seeing patients.

I wrote up a press release to turn in to the local weekly newspaper. Their deadline was Friday and came out on Wednesday. That would allow a little more than a week for people to find out about it. I contacted another local family doctor who had just gone to Haiti to help in their relief effort to see if he would be interested in taking part. He was, so I added his name to the press release. I also sent the press release to the local chamber of commerce for distribution to local businesses, many of whom I figured would have uninsured employees, and a press release to the larger local paper.

I decided at the time to limit it to only South Pasadena residents and employees of South Pasadena businesses because I didn't think we could handle it if there was a huge response. 

Finally the article was published on Wednesday March 17th and . . . we waited. No one called. Friday morning, the chamber of commerce sent out an e-mail announcing the offer. One person called and scheduled an appointment.

OK, I thought, maybe I miscalculated. Either there aren't a lot of uninsured people in South Pasadena, or there wasn't a pressing need for medical care at this time. I mean, a one day offer of free medical care isn't going to cut it for chronic diseases such as diabetes or hypertension. Or the message wasn't reaching the right people. Our small town paper has a circulation, I'm told, of about 4000.

So I sent a modified press release to the local public radio station and a local TV station. This time, the offer was for anyone without insurance. Since I had no response from my press release, I called the local newspaper and spoke to a reporter who immediately sounded interested when I told him of our idea. But it was already late Friday morning and there wasn't enough time to come do an in-depth interview before the weekend. So he wrote up something quick and posted it to the website. 

Unfortunately, there was no link to the article on the main page of the newspaper, so the only way anyone could find it was to do a Google search. I e-mailed the press release to 3 more local TV stations but it was the weekend and I got no response. It was looking bleak. On the positive side, the healthcare reform bill was being passed by the House. On the negative side, I had only 3 patients scheduled for "Pay What You Can Day".

This morning I talked with the reporter again and he said that there was an article published in today's printed newspaper, and he would make sure that the article was posted with a link to the main page this time. And so he did:
"South Pasadena doctors to give free medical care for a day"
I've had one call so far from this article. It is 5:19PM. Hmmm. Still not looking so good.

Maybe everyone will call tomorrow morning. Or maybe a bunch of people will just walk in tomorrow. Or maybe, just maybe, nobody needs free healthcare right now?