Each weekend across the United States, long lines of people form before dawn at pop-up clinics that offer free medical, dental and vision care. Run by Remote Area Medical (RAM), these volunteer-run events can be life-changing — yet a tangle of state laws often keeps clinicians from treating as many people as they might.
At a recent clinic, Dave Burge sat in a dental chair and inspected a new set of dentures in a hand-held mirror. He had lost teeth twice — first in a head-on crash caused by a drunken driver and later on the job when a drill recoil struck his mouth. Seeing the fitted dentures for the first time, he smiled broadly. The prosthetics, provided by volunteer clinicians, restored more than his teeth: they restored confidence and everyday function.
RAM serves thousands each year. Founded in the 1980s by Stan Brock, who originally traveled to remote regions of South America to deliver care, the organization shifted its focus to underserved communities in the U.S. Its principle is straightforward: treat anyone who shows up, no questions asked. About half of RAM’s patients are uninsured; many of the rest have coverage they cannot afford to use because of high co-pays and deductibles.
Interest in RAM surged after a 2008 CBS report that sparked substantial donations and volunteer sign-ups. Where the group once ran about a dozen clinics annually, it now hosts roughly 90. At a recent event in Knoxville, volunteers treated about 1,200 patients, with people lining up well before sunrise for dental work, eye exams and basic medical care.
But the reach of these clinics is curtailed by regulatory hurdles. Chief among them is the patchwork of state licensing requirements that often prevents doctors, dentists and other clinicians from crossing state lines to volunteer without a local license—even for short-term charitable work. Brock helped inspire Tennessee’s Volunteer Health Care Services Act of 1995, which permits out-of-state clinicians to provide volunteer care in that state. Several other states have enacted similar laws, but many restrictions remain nationwide.
Today RAM is led by CEO Chris Hall, who says licensing barriers continue to blunt the organization’s impact. “Clinicians train and practice across state lines during their education and careers,” Hall said, “but state licensure limits their ability to volunteer where the need is greatest.”
Volunteers travel long distances to staff clinics. Dentist Glen Goldstein flew in from New Jersey to work at the Tennessee event and said it is frustrating to be unable to volunteer in neighboring states because of licensure rules. “The care I provide is the same everywhere,” he said. “There are so many professionals willing to give their time, but state licensing can block them.”
Some advocates, including Goldstein and RAM leadership, call for federal legislation or broader interstate compacts that would allow medical volunteers to serve across all 50 states, modeled on international humanitarian responses such as Doctors Without Borders. Hall argues that loosening those rules would expand access to care and reduce the administrative burden involved in organizing clinics.
For now, demand for RAM’s services remains high. Brock once said he hoped the organization would ultimately make itself unnecessary; two decades later that goal still seems far off. For patients like Sandra Tallent, who drove 200 miles and slept in her car to reach a clinic and left with new dentures, the clinics are nothing short of transformative. “I’m so grateful,” she said after seeing her new smile. “I don’t know what I’d have done without RAM.”