BusinessTN

When President Barack Obama visited Bristol last July, he missed a golden opportunity just across the border in Wise, Va., to witness hundreds of citizens without health insurance receiving quality primary medical care at no cost to the patients -- or taxpayer -- courtesy of Remote Area Medical (RAM).

"[It's] not a solution to the health care problem, but it's a damn good place to start," says Stan Brock, British-born founder of Knoxville-based RAM -- a nonprofit foundation that organizes expeditions of volunteer physicians, eye doctors, dentists and support staff to set up weekend-long events in large venues that closely resemble a disaster recovery effort, servicing long lines of people waiting to be seen for issues as simple as a tooth extraction or an exam for new eyeglasses.

He is not a doctor, nor does he have a formal medical or even a social work background. But since 1985, Brock has dedicated his life to bridging the divide between people and medical care -- whether that means tribe members living in the isolated Amazon rain forest or the poor in rural Appalachia.

To date, RAM has hosted 581 events, treating more than half a million people with the help of 45,000 medical and support volunteers in remote areas overseas and across the United States. That equates to $40 million worth of free care.

RAM is largely supported by small donations, and volunteers pay their own travel, lodging and food expenses. While many patients seen at these events are local, it's not uncommon for people to drive hundreds of miles and wait up to 12 hours prior to RAM opening its doors just to be seen by a doctor, no questions asked.

Today, Brock says 64% of its medical relief efforts are held stateside, and in more urban settings, as the number of Americans without jobs and insurance coverage increases. Brock likens the inaccessibility of health care service in this country to a state of emergency.

"When you look at one of these massive operations, it just looks like somebody is coping with the aftermath of a hurricane or an earthquake. It really does fit into the category of disaster training," he says.

His experience garnered him an invite to Washington, D.C., in October 2009 to appear before a subcommittee hearing titled, "Insured but Not Covered: The Problem with Underinsurance."
His talk focused on RAM's primary problem: the need for more medical professionals to participate in RAM events. To do that, doctors need to be permitted to practice outside of the state in which they are licensed. Tennessee is the only state that allows this (which is why so many of RAM's events are held here) under the Volunteer Health Care Services Act of Tennessee, passed in 1995 and originally sponsored by state senator C. Coulter "Bud" Gilbert.

Two years later, U.S. Rep. John J. Duncan Jr., introduced House Concurrent Resolution 69 in an effort to persuade states to adopt the Tennessee model, but it fell flat even after being endorsed by the American Medical Association.

Brock recalled for the subcommittee the disappointment he felt after the eight-day expedition in urban Los Angeles in August 2009. While the event was sponsored by record executive Jerry Moss (the "M" in A&M Records) resulting in $2.8 million worth of free care for 6,344 patients, Brock had more equipment than doctors.

"We had 100 dental chairs and 20 lanes of eye exam equipment; yet on some days, we could only recruit 25 California-licensed dentists and five or six eye specialists," he told the subcommittee.

Why the hesitation of permitting doctors to practice out of state? Dr. Yarnell Beatty, director of legal and government affairs with the Tennessee Medical Association, says that while education requirements and qualifications for doctors applying for licensure do vary from state to state, there are exceptions where doctors will practice across state lines in emergency situations such as Hurricane Katrina in 2005. (RAM provided primary care during that catastrophe by physicians not licensed in Louisiana.)

The RAM event in L.A. was not considered an emergency.