Bid to Help Poor Mothers Marks Birth of Good Idea

The San Diego Gynecologic Society has found a relatively simple, yet creative, tactic to divide and conquer at least part of a major health problem here. The society is asking its members to treat at least one pregnant woman a month who has no other means of obtaining care. By dividing up the task, the society’s 167 members could treat about half of the approximately 300 women who deliver babies each month in San Diego County with no prenatal care.

And, if all of the county’s 230 gynecologists saw a woman a month, three quarters of the women needing care would be able to get it.

That’s too optimistic, of course. Some physicians are already taking nonpaying patients, and others will not participate. And some women, particularly those addicted to drugs, will not avail themselves of the service.

Nonetheless, the society decided that it had to take some action. San Diego has the state’s highest rate of no-care deliveries, and doctors end up delivering the babies in hospital emergency rooms under high-risk conditions. So the volunteer program will help doctors as well as mothers and babies. What’s more, it will save money. Studies have found that, on average, every dollar spent in prenatal care saves $3 to $4 in later care.

The Gynecologic Society is to be congratulated for its innovative program, which initially will be organized through a grant from the Irvine Foundation. And it’s a program worthy of imitation. The possibilities are intriguing.

For instance, what if physicians in other specialties were to adopt similar plans? The American Medical Assn. recently recommended that doctors donate 50 hours a year in care to the poor. In San Diego County, that would amount to about 225,000 hours of free care.

If psychologists did likewise, it could take some of the sting out of the cutbacks in mental health funds.

What about dentists? Or lawyers? The American Bar Assn. last year passed a resolution saying that attorneys should donate 50 hours a year in professional services.

All of these professions have members who volunteer selflessly, and some are putting more of an emphasis on volunteerism. For instance, the San Diego Volunteer Lawyer Program, sponsored by the San Diego County Bar Assn., says that the number of attorneys with major law firms who are participating has risen from 10% to about 20% in the past year.

But much more is needed. Using Bar Assn. estimates, for instance, the Volunteer Lawyer Program calculates that 65,000 to 75,000 San Diegans whose incomes are at or below the federal poverty line need legal services each year, and that only 20%-25% of that need is being met by existing legal-aid services.

And the county says there are thousands of San Diegans who do without medical and mental-health care because they can’t afford medical insurance, don’t qualify for Medi-Cal and are not sick enough for county programs for the poor.

To be sure, volunteer programs are not a substitute for insurance or more government aid. But they can help close the gaping holes in society’s safety nets.