The Homeless Clinic Fired Me

     A month after closing Colasante Clinic I commenced volunteer work at Helping Hands, a homeless clinic on the east side of Gainesville.
     Many patients at this clinic come from Tent City, Gainesville's tent-slum, where there are no sewage services, sidewalks or running water.  Other patients have makeshift shelters in the unlit field behind the Toyota dealership on North Main--I know, because I've driven them "home."  Some camp out under blankets on the sidewalks of the downtown plaza, and a few get temporary shelter on cold nights with people they knew in the past-- people whose friendship is strained by cohabitation with a (usually depressed) (often unclean) (hungry) person of no means.  Twice a week the homeless clinic provides hot dogs, showers, second-hand clothing, blankets, tents, bus passes, insect repellant, sunscreen and rudimentary medical care--all free.
     I felt good about working at Helping Hands.  Four of my old patients, displaced after the closure of Colasante Clinic, registered as patients at this free clinic and would shout, when I arrived, "Dr. C!  Can I see you?  Can I?"  I continued my care for them under a different roof.  I developed relationships with many other patients, and I learned a lot about homelessness in Gainesville.  The other doctors and providers were my  new colleagues;  some had been serving in this clinic for years.  I liked the patients, whose appreciation was abundant and whose personalities had been pared down to the core:  no hauteur, no scorn, no pretense, no false pride.
      I wonder why, in America, we depend on nonfederal homeless clinics for the delivery of healthcare?  Every year 3.5 million people are homeless, and most have no other option for medical care.  Homeless clinics depend on donations and occasional small grants, and they operate with bare-bones budgets.
     If every physician in the country agreed to see one homeless patient a day for free, this grievous problem would be solved.  If the government funded homeless clinics with a minuscule portion of its military budget, we could claim to be a compassionate country.  If physicians didn't live in fear of lawsuits, they might donate more free care.  If they could itemize the cost of free care on their tax returns, maybe homeless clinics as they exist now would disappear.
     Last week when my lawyer told me, "You're going to be indicted any day," I told the administrator of Helping Hands, during my next shift, that there might be negative publicity about me in the upcoming days.  I mentioned what my lawyer had said.
     My lawyer had told the prosecutor that I would turn myself in--no need for public drama.  But the prosecutor, smacking his lips, said, "No, we're going to do this the old-fashioned way!"
     I was wearing my stethoscope and calling a patient to the exam area when the homeless clinic administrator, having given it a few minutes' thought, interrupted me.
     "I think you should stop working here," he said.
     "Really?"
     "Yes, it's not a good idea, in light of everything."
     Now, if the prosecutor were to capitalize on any prospect for indicting me, he would have to jockey it out of the False Claims Act, a bucket chock-full of options for assembling a civil complaint against just about any Medicare provider.
     But the homeless clinic doesn't code, bill, or charge for its services.  The doctors work for free.  The clinic has "sovereign immunity," which means neither the clinic nor its volunteers can be sued.  The clinic needs doctors.  And I'm free.  I have a medical license and Board certification, and I've practiced medicine without pause and without a lawsuit for twenty-four years.
     "You know that I haven't been charged, arrested, or convicted, right?" I reminded the administrator.  "This case has been going on for three and a half years.  I'm innocent, and I might not be indicted."
     He pressed his lips together, and shook his head.
     "Why don't you come back when everything's blown over..." he said.
     He was still looking at me, but he was also walking backward, putting distance between the two of us, until he was almost in the break room..
     I had become someone with a contagious disease.  He didn't want to be next to me.  Government scrutiny is a contagion.  The government has infected me, and in my quarantine I can count on one hand the number of colleagues standing by me.