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Practicing Medicine without Politics

Volunteer physicians enjoy camaraderie at free clinics, made possible by state’s strong sovereign immunity law

Every Monday afternoon, retired Clearwater cardiologist Paul Kudelko, DO, FACC, heads to the Clearwater Free Clinic in Clearwater to volunteer with third-year residents from Nova Southeastern University near Fort Lauderdale. He’ll return on Thursday morning to see patients.

In Orlando, internal medicine specialist Doris Cameron, MD, spends eight hours a week volunteering at Shepherd’s Hope, and a half-day on Friday at Grace Medical Home.

Besides being motivated by the pure enjoyment of practicing medicine without the politics while also giving back to their local communities, both physicians say volunteering in the free clinic arena is only possible because of Florida’s strong sovereign immunity laws.

“Many physicians shy away from volunteering at free clinics because they don’t understand how sovereign immunity covers them completely,” said Cameron. “If physicians were better educated about how sovereign immunity works in Florida, more would volunteer. Until then, their concern about liability remains a significant barrier.”

Cameron began volunteering in 2009, three years before Florida lawmakers strengthened the sovereign immunity law. Initially, she volunteered at Shepherd’s Hope a few hours a week. The mother of three added Grace Medical Home to the rotation when it opened in 2010.

“I was so concerned about the liability that I kept my medical malpractice insurance for a year while I researched the state’s sovereign immunity law to see if it really worked,” she said. “After I looked into it and saw the law had held up to challenges, I relaxed.”

In Clearwater, Kudelko retired in 2010 and spent a year establishing a new lifestyle that included a couple of extended vacations with his wife, Debbie, and reading “more books in a year than my entire lifetime,” he said.

“When you’re a physician, you read for educational purposes, which is important in the field of cardiology that changes so much,” said Kudelko.

But Kudelko yearned to return to the practice of medicine in some aspect. In December 2011, he joined the volunteer staff at Clearwater Free Clinic. When the sovereign immunity laws were improved in 2012, it gave him the peace of mind to add more hours.

“As a retired physician, I do what’s needed to maintain my license, which includes 50 hours of post-graduate or CME credits every two years,” he said. “That’s a financial responsibility of my own. If I wasn’t able to have sovereign immunity, I’d also have to pay quite high fees for medical malpractice insurance. It would be unfeasible to volunteer.”

Cameron had been in private practice for decades and was growing frustrated with the changes in the practice of medicine that were, she said, “getting in the way of practicing medicine.”

“I was given five or 10 minutes to see a patient. I had to be careful about referrals,” she said. “When I volunteer, it’s pretty much my time. We don’t have a lot of specialists, so I can use the knowledge I have to treat the whole patient. I love doing that.”

Recently, Cameron diagnosed a male patient with ALS. He had been to the emergency room several times, didn’t have access to routine medical care, and his symptoms had grown progressively worse.

“Basically, nobody was able to diagnose him,” she said. “It was a bad diagnosis to give, but it was necessary for him to have an answer and find ways to improve the quality of his life.”

Kudelko also sees patients with symptoms he normally doesn’t find in cardiology work, and appreciates the teamwork environment at the free clinic.

“I like the challenge and the fact that we help each other a lot,” he said. “Having politics as an eliminated part of the equation makes a substantial difference. There are no petty jealousies. Patients sense that. On the flip side, every doctor knows you might get patients who are cranky when they come into the clinic. They’re hurting and don’t really want to be there. By the time they leave, their spirits are much improved. They feel supported by a group of medical providers who really want to be there. That in itself is extremely rewarding.”

Kudelko, a board member of the Clearwater Free Clinic since 2012, was surprised to learn that 70 percent of patients at the free clinic hold a job but don’t qualify for medical care.

“It seemed the intent of the Affordable Care Act was to close the gap, but instead it’s widened the cracks,” he said. “The patient population is very appreciative that someone’s there to help.”

Kudelko was familiar with the Clearwater Free Clinic when he was in private practice. He was also in charge of the internal medicine residency program at Suncoast Hospital, now Largo Medical Center in Largo.

“At that time, we used the free clinic for outpatient training of our residents,” he explained. “Then the hospital developed its own outpatient clinic and our residents no longer went to the free clinic, unfortunately. But for quite a few years when we were involved, I was there once a week reviewing charts.”

Returning to the free clinic in a volunteer capacity to mentor residents “is such a pleasure,” said Kudelko.

“Even though it’s a learning experience for these young people coming up as I mentor them, they give back to me in more ways than they could imagine,” he said. “The sovereign immunity law makes it all possible.”

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