Last November, I found myself in the rural town of Cleveland, Tenn., witnessing retired physicians hurl expletives against existing medical licensure policy. Sitting in a public high school classroom that had been converted to a temporary medical exam room, I had broached a sensitive subject for this group of retired doctors, now dedicated to volunteer work with an organization called Remote Area Medical (RAM).
RAM is a nonprofit organization based in Tennessee that orchestrates large-scale pop-up clinics throughout the nation. A few years ago, Emory University students organized a RAM chapter to plan their own clinics and coordinate student volunteering with RAM. I joined the Emory chapter shortly after arriving on campus and was assigned the duty of helping recruit physicians for a clinic in Louisville, Ga., which will be hosted by our chapter later this month.
At this RAM clinic in Cleveland, Tenn., I began speaking with these retired physicians and perceived an ideal opportunity for recruitment: Physicians dedicated to RAM’s cause would certainly be interested in volunteering at our Georgia clinic. This inquiry prompted my discovery of Georgia’s flawed licensure policy — these Tennessee physicians could not cross into Georgia to legally provide volunteer services for a weekend pop-up clinic.
Dr. William Moss, a retired OB-GYN who frequently travels with RAM, remarked that Georgia is a “closed” state, a term denoting a place where outside physicians are unable to enter and volunteer; volunteer licensure policy differs widely on a state-by-state basis. As a Tennessee physician, Moss was informed he must pursue the lengthy and expensive process of obtaining a permanent Georgia physician license should he wish to provide free care in the state. Obtaining a permanent license, according to the Georgia Composite Medical Board, takes six to eight weeks and requires a $500 application fee, unjustifiable for out-of-state doctors interested in volunteering.
Given the lack of trained doctors near Louisville, Ga., hearing that these physicians would not be able to volunteer at the clinic was certainly discouraging. I nevertheless could not fault them for refusing to take part in the Medical Board’s inordinate and costly regulations.
Georgia Code Section 43-34-41, the “Georgia Volunteers in Medicine Health Care Act,” last amended in 2009, theoretically authorizes the Medical Board to administer temporary volunteer licenses, although the physicians in Cleveland, Tenn. reported being unable to obtain a temporary license under current Medical Board policy.
Conversely, the Volunteer Health Care Services Act in Tennessee, passed in 2015, clearly specifies that “no additional license … is necessary for the volunteer provision of health care services.” Physicians from outside states can fill gaps in care without burdensome regulation. Tennessee is an “open” state, so organizations like RAM can recruit doctors from all over the nation to volunteer.
I met with RAM CEO Jeff Eastman to speak with him about RAM’s battle against volunteer licensure policy, and he immediately lamented the organization’s difficulties in bringing volunteers to the state of Georgia. Our state has accrued a reputation among medical volunteer groups, unbeknownst to many members of the public.
When physicians are forced to remain segregated by state boundaries, coordinated initiatives to provide care to desperate populations cannot occur at the national level. Instead, volunteer medical services find themselves unduly sequestered and care delivery is limited.
Emory’s chapter of RAM hosted the first-ever RAM clinic in Georgia only two years ago in 2021, and the paucity of RAM clinics in Georgia is certainly not unrelated to the onerous process of bringing out-of-state volunteers.
The Georgia state government must enact a bill mirroring the Tennessee Volunteer Health Care Services Act to remove the burden of seeking an unobtainable volunteer license or permanent licensure, allowing organizations like RAM to readily deliver needed medical services to underinsured populations.
At Emory, pre-medical organizations, including our RAM chapter, could leverage their sheer size to influence this policy, with leaders instructing members to write to local representatives about licensure.
State sovereignty is not undermined when outside volunteer services are delivered. The objective is not to allow non-Georgia physicians to open for-profit practices without permission from the Medical Board. Instead, Georgia must legalize the entry of dedicated physicians to our state to help alleviate the scourge of desperate patient populations in light of spotty insurance coverage.
Zachary Paikin (26C) is from Vienna, VA.