South Carolina Program of Physician Volunteers and Health Clinics

You asked for information on a South Carolina program using retired physician for health clinics for the indigent.

In 1993, the South Carolina legislature authorized the State Board of Medical Examiners to establish a special volunteer license, designed to allow retired physicians to work in clinics and other settings providing free medical care to the needy. The special license can be issued to a physician meeting the board's criteria and whose practice is exclusively devoted to providing medical care to the needy and indigent. Such special licensees can only practice under a supervisory physician approved by the board. License and application fees are also waived.

South Carolina law also limits the liability of clinics and their employees when providing services on a voluntary basis.

In 1993, the South Carolina legislature approved the establishment of a "special volunteer license" designed for those physicians wishing to provide medical services to the indigent and needy of the state. This special license, which most likely will be applied for by retired physicians, also involves a waiver of all application, examination, and annual registration fees.

A physician applying for this special license must satisfactorily document to the South Carolina State Board of Medical Examiners that his practice is to be "exclusively and totally devoted to providing medical care to the needy and indigent in South Carolina," (S.C. Medical Board Regs. § 81-75).

To be eligible for the fee waivers, the physician must acknowledge that there is no expectation of payment or compensation for rendering medical services (Regs. § 81-75).

The special volunteer license, which is renewable annually, limits the physician's practice to specific sites and practice settings. Specific requirements for the license are as follows:

1. satisfactory completion of a special volunteer license application, including documentation of medical/osteopathic school graduation and practice history (see attached application);

2. documentation of specific proposed practice location(s);

3. documentation that the applicant was previously issued an unrestricted license to practice medicine in another state and that the applicant has never been disciplined in any jurisdiction;

4. documentation that the applicant will only practice under the supervision of a supervisory physician approved by the board;

5. documentation of the name of the supervisory physician and that he has agreed to accept this responsibility; (all supervisory physicians must have an active, unrestricted permanent license to practice in South Carolina and an approved supervisory physician must physically be on the premises whenever a special volunteer licensee is practicing); and

6. documentation and acknowledgement that the applicant will receive no payment or compensation, either direct or indirect; also, the supervising physician shall not receive any compensation or payment as a result of the special licensee providing medical services (Board Regs. § 81-75).

No special volunteer licenses have been issued to date according to Marian Westbrook of the State Board of Medical Examiners of South Carolina. There are applications pending.

The Hilton Head clinic, which has received national attention, is staffed by a medical director, who has a standard, unrestricted license to practice medicine in South Carolina. Mrs. Westbrook is aware of an applicant for special voluntary licensure from that clinic.

Under South Carolina law, a licensed health provider who gives medical services voluntarily and without compensation is not liable for any civil damage for any act or omission resulting from giving those services unless the act or omission was the result of the provider's gross negligence or wilful misconduct. The agreement to provide voluntary, noncompensated medical services must be made before services are rendered (South Carolina Statutes, § 33-55-210(B)).

South Carolina also limits the liability of "charitable organizations," such as health clinics and their employees. If the clinic receives some type of payment for the health services provided (e.g., Medicare, Medicaid, or a reduced payment from the patient), there is a $200,000 cap on the liability of the clinic and its employees when they have committed ordinary negligence. There is no cap if the clinic or its employees committed reckless, wilful, or gross negligence (§ 33-55-210(A)).

If the clinic receives no payment for services rendered, there is no liability if the clinic or its employees have committed ordinary negligence. There is a $200,000 cap if the clinic and its employees committed reckless, wilful, or gross negligence (§ 33-55-210(A), (B)).