REINVENTING RETIREMENT
In Marc Freedman’s book, Prime Time: How Baby Boomers Will Revolutionize Retirement and Transform America, he writes about once-retired physician Jack McConnell whose vision for “Volunteers in Medicine” embodies the spirit of the Purpose Prize. Here is an excerpt:

When Jack McConnell was a child, his father, a Methodist minister working in Tennessee and West Virginia, eschewed owning a car for fear that he could not “support Mr. Ford” and ensure that all seven McConnell children had the opportunity to go to college. So he did a considerable amount of walking as he carried out his ministerial duties. He was also fortunate to receive many rides from friends and neighbors, and this early experience instilled in the younger McConnell—who went on first to become a pediatrician and later a corporate executive at McNeil Laboratories and Johnson and Johnson—a lifetime habit of giving a lift to others.

This habit ended up playing a pivotal role in altering McConnell’s retirement plans. Having done well financially, well enough to retire to a large house in one of Hilton Head’s poshest gated communities (he played a role in the development of the MRI, Tylenol tablets and the Tyne test for TB), McConnell was planning on a leisured ‘third age’ with his wife—many rounds of golf, a steady diet of upscale dining and long hours of reading on their deck overlooking the water. However, this lifestyle didn’t work for the energetic McConnell. “I soon realized my fulfillment would not occur on the golf course,” he recalls in “Circle of Caring,” his essay about creating the first Volunteers in Medicine clinic in Hilton Head, South Carolina. “If anything, it diminished me more than I would have liked.”

This desire for a more fulfilling retirement was becoming clear at the same time that McConnell was realizing the real town of Hilton Head was not quite the one advertised in all the Chamber of Commerce brochures aimed at luring affluent retirees to the resort community. The PR conveniently neglected to mention that alongside all the upscale snowbirds like the sixty-four-year-old McConnell, were a great many native islanders and others employed as maids, gardeners and servants living at or near the poverty line—nearly one-third of the island’s population.

In many cases, the haves and the have-nots were divided literally by walls of gated communities. On the inside, McConnell and his peers lived in palatial houses distributed around golf courses and waterways, while on the outside, working people scraped by in unheated shacks without running water or sewers. The contrast became a galvanizing force for Dr. McConnell. Referring to his regular trip from the gated community to town, he commented in 1993: “It’s a short drive, but a hell of a long journey… sitting cheek by jowl, you couldn’t ignore the squalor.”

McConnell was in the habit of driving out the back gate of the community and of giving rides to workers walking home along the side of the road. These encounters taught him something further: that these men and women—most of them earning the minimum wage—rarely had any health coverage. Meanwhile, he was spending his days on the golf course with scores of retired physicians and dentists who, it seemed to him, were restless, bored and lacking real purpose in their lives.

The idea of bringing these two groups together, of devising a new route to providing inexpensive health care to the working poor while creating new roles for retired medical professionals, became an obsession for him. As he began testing out the notion with his friends and contacts around town, McConnell became increasingly convinced that a free clinic staffed by retired physicians, dentists and nurses was not only a good idea in theory, but also a viable proposition.

Along the way, McConnell did encounter some resistance from local physicans convinced that an operation of this sort might end up competing with them. (For what? McConnell asked. Nonpaying patients they weren’t treating anyway?) However, he also acquired a pair of key allies in the CEO of the local hospital and its director of emergency medicine. They were concerned about the mounting costs of nonpaying patients in their ER, individuals who required urgent care after untreated conditions became medical disasters. These were costs they were required by law to bear and they felt a clinic like the one McConnell was proposing might save them money and help avert some of these personal crisis by providing individuals with care earlier in the process.

Once the clinic idea began taking shape, there was essentially no stopping McConnell. Courtly on the exterior but relentlessly hard-driving underneath, he commented in 1995 that once he got rolling he “never looked back,” even if the process wasn’t always a smooth one. According to McConnell, “I kept moving forward. I just didn’t know how many bumps we were going to hit in the road.” But he tirelessly built local support for the clinic, by then named Volunteers in Medicine…

By 1997, a little over five years after initially conceiving of the notion, McConnell was overseeing an operation involving three dentists, 44 retired physicians, 64 nurses and 138 lay volunteers who treated 6,000 patients a year-an average of about 50 a day on those days the clinic was open. The annual budget of just under half million dollars covered upkeep of the facility and salaries of five full-time and two part-time paid staff, including among the full-time staff a medical director, nursing director, development director, and office manager.

As Jack McConnell envisoned, patients of Volunteers in Medicine are overwhelmingly working-poor men and women who neither qualify for Medicaid nor are covered by private health insurance. For them, the clinic is a place of last resort. And based on the overall cost of $35 per patient visit to the clinic, Volunteers in Medicine saves the local hospital between $350,000 and $500,000 annually. In fact, Steven Caywood, President of Hilton Head Hospital, estimates that it costs his emergency room twenty times as much as Volunteers in Medicine to treat the same cases.

On a social level, Volunteers in Medicine is regarded by many in Hilton Head as one of the town’s few bridges between the large numbers of wealthy retirees who have relocated there and the far less affluent, and often younger, local population. According to Thomas Barnwell, an African American community leader and third generation Hilton Header, the clinic is, “the glue” of this community, one that connects individuals from dramatically different circumstances and “binds them together… like nothing before.”

The clinics reputation spread beyond Hilton Head quickly. By 1995, Jack McConnell had received 492 requests from towns around the country interested in setting up variations on the Volunteers in Medicine clinic. In response to this outpouring of interest, McConnell passed on the operational reins at the clinic in October of that year to devote all of his time to helping other communities adapt Volunteers in Medicine to their particular circumstances.

Copyright 1999 Marc Freedman