and vein injections for non-healing venous stasis
ulcer procedures in the clinic. On a typical half-day,
about 14 patients undergo surgery and another 14 to
20 will have flexible sigmoidoscopy or colonoscopy.
By addressing the health care needs of the community’s most vulnerable population, Project Access San
Diego helps to prevent life-threatening or chronic
medical conditions in uninsured patients.
How did Project Access San Diego get started?
The Project Access model started in North Carolina
in 1996.5 The physician members of the Buncombe
County Medical Society, now the Western Carolina
Medical Society, recognized the need for access to
all aspects of health care for low-income, uninsured
residents of the community. With a demonstrated
commitment from physicians and other community
partners, Project Access was able to begin providing
care to these individuals.
5, 6 There are now approximately 100 volunteer programs similar to Project
Access across the country, which indicates that this
model is relatively easy to implement in other areas
of the U.S.
In 2008, Kaiser Permanente San Diego partnered
with Champions for Health to provide two half-day
events per year at Kaiser Permanente outpatient sur-
gery centers, which are called Saturday Surgery Days.
Daniel “Stony” Anderson, MD, a now-retired gastro-
enterologist and member of the Southern California
Permanente Medical Group Board, was instrumental
in obtaining support for this partnership from the
leadership of Kaiser Permanente San Diego. I was
invited to be the surgical lead for the project by Mark
Schumacher, MD, FACS, former medical director of
operating rooms at the Kaiser Foundation Hospital
in San Diego, CA, who was aware of my interest in
What is the health care situation in the area
served by Project Access San Diego?
San Diego is considered home to one of the most
sophisticated health care systems in the country. San
Diego hospitals hold some of the highest ratings for
both overall care and unique specialties. For example,
in 2016, the University of California San Diego Medi-cal Center was named the best health care facility in
the region and sixth best in the state, according to U.S.
News & World Report’s annual Best Hospitals issue.
Diego is home to 25 hospitals, and more than 26,000
unique health care and social assistance establishments
that employ more than 140,000 people.
many residents of San Diego County are unable to
access these services.
What is the ratio of physicians to patients in San
The San Diego County area has approximately 64
primary care physicians (PCPs) per 100,000 residents
(recommended supply is 60–80 PCPs per 100,000
residents) and 147 specialists per 100,000 residents
9 Overall, California rates
are 64 PCP and 130 specialists per 100,000 residents.
JUN 2017 BULLETIN American College of Surgeons
Dr. Freiwald (second from left)
receiving the Domestic Volunteerism
Award at Clinical Congress 2016, with
(from left) Francis D. Ferdinand, MD,
FACS, ACS Board of Governors (B/G)
Executive Committee; Bartholomew
Tortella, MD, FACS, senior director,
medical affairs product lead,
hematology and transplantation,
Pfizer, Inc.; Fabrizio Michelassi,
MD, FACS, then-Chair of the ACS
B/G; and Frank W. Sellke, MD, FACS,
Chair, ACS Surgical Volunteerism and
Humanitarian Awards Workgroup