Reach Out encourages locally based groups of physicians to design innovative approaches that expand primary care services for people who lack health insurance and the ability to pay for medical care. In this chapter of the Anthology, Wielawski explains how the program works, describes some of the innovations that have been implemented, and outlines the complexity of doing volunteer work in the emerging world of market-driven health care.
Irene M. Wielawski was charged with doing an evaluation of the project, but she is far from the standard evaluator. Before accepting the Reach Out assignment, she was an investigative reporter for the Los Angeles Times. Rather than using traditional social science evaluation methods for this project, the Robert Wood Johnson Foundation decided that an investigative reporter was best equipped to sort through the experiences and draw lessons that might emerge from them. Narrowly defined access outcomes are of less interest in this evaluation than are the defining qualitative stories and lessons about how to encourage volunteerism. Physicians historically have provided large amounts of charity care to needy patients; the challenge considered herein is how this commitment can be translated to the 1990s medical care environment.
- 1. Editors' Introduction
- 2. Reach Out
- 3. A Review of the National Access-to-Care Surveys
- 4. Improving the Health Care Workforce
- 5. Expertise Meets Politics
- 6. The Media and Change in Health Systems
- 7. Addressing the Problem of Medical Malpractice
- 8. Unexpected Returns
- 9. Developing Child Immunizations Registries
- 10. The Homeless Families Program
- 11. The National Health and Social Life Survey