Retired docs vital volunteers

Dave Strupp
http://jacksonville.bizjournals.com/

JACKSONVILLE — Dr. Robert Duncan practices medicine after retirement because he enjoys it too much to stay away.

“I do it because practicing medicine is lots of fun,” he said.

After 33 years as a plastic surgeon, 25 of which he spent as chief of plastic surgery at St. Vincent’s Medical Center, Duncan retired from the hospital four years ago. But he volunteers once a week at The Sulzbacher Center‘s clinic and once a month with We Care Jacksonville clinics where he works with indigent patients and teaches nurse practitioners, physician assistants and medical assistants.

“They watch us and we teach them as we go along,” he said.

If care were not provided by the community health services, many of the indigent in Jacksonville would either go without care or improperly use hospital emergency departments for services that could be taken care of by a primary care physician. In Florida alone in 2006, hospitals incurred $2.35 billion in uncompensated care costs, according to the Florida Hospital Association.

Community health services in Northeast Florida consist of a network of health providers and community organizations, many of which rely on the volunteer efforts of health-care providers in town.

“We need more retired doctors to do this,” Duncan said. “It makes me want to read more about medicine, and keep up with things.”

Duncan and many other retired physicians likely would not be able to practice medicine without several legal protections afforded to them by their former malpractice insurance companies and the state of Florida.

Retired physicians retain some form of medical malpractice coverage to cover the possibility of a retroactive claim being filed. Once a retired physician begins to practice again and get compensated for practicing, the coverage is void.

“You can’t work for money, but you can volunteer,” Duncan said. “I’d prefer to work as a volunteer” at this point.

“Tail coverage” is optional protection that allows a physician to report malpractice claims after a policy has ended for alleged injuries that occurred during the time the physician’s policy was in force.

For example, if a physician were to discontinue a policy he had for five years in 2005 and retain tail coverage he could report a malpractice claim filed by a patient from a procedure in 2004. But tail coverage can be voided if it is discovered the retired physician still makes money from practicing.

Jacksonville-based First Professionals Insurance Co. decides on a case-by-case basis whether or not to allow a retired physician to retain tail coverage while practicing, but certainly will not allow retention if the physician is making money from practicing, said Laura Archer, vice president of underwriting for the company.

FPIC requires physicians be covered for five years with no gaps in coverage before offering tail coverage, which is also a market standard, Archer said.

Insurance companies are required by the state to let retiring physicians know the availability of tail coverage, said Earl Googe, a malpractice lawyer and shareholder with Jacksonville law firm Smith, Hulsey and Busey.

Many companies will offer tail coverage as an option for a nominal fee, and sometimes for no fee, because they’ve already received the benefit of the premiums paid by the physician in the past, Googe said.

Duncan is covered by Miramar-based ProAssurance Corp. He is required to register under the Florida Department of Health’s Volunteer Health Services Program for practicing at the We Care clinics, which provide free medical care to the indigent population throughout Jacksonville, and said he is given sovereign immunity under the program.

The program allows private, licensed health-care providers to volunteer their services to Florida residents with incomes at or below 200 percent of the federal poverty level while under the state’s sovereign immunity, which protects physicians from lawsuits pertaining to unintended outcomes.

“I wouldn’t be able to do it unless I have sovereign immunity,” Duncan said.

Since We Care Jacksonville is a network of clinics, including Sulzbacher, under his volunteer license Duncan is able to practice at each of the clinics.

“I thought we, as doctors, could go out and volunteer anywhere,” he said. “But actually we get papers from the state to get cleared for that. It’s an organized system with sovereign immunity.”

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