Dr. Demetrio Aguila was tired of hearing stories about patients' who found themselves saddled with crushing medical debts.
"I felt helpless," Aguila, a nerve and plastic surgery specialist based in Nebraska, told CNN. "I realized I needed to try to make things different."
Every year, medical expenses force about 530,000 families into bankruptcy, according to the American Journal of Public Health.
Rather than watch his patients drown in medical debt, the surgeon decided he wanted to find a solution that worked for him and his patients.
So he partnered with several local charities to start the M25 program, which enables his patients to "pay" for surgery with community service hours instead of dollars.
How the M25 program began
Aguila's inspiration for the name "M25" comes from the twenty-fifth chapter in the gospel of Matthew in the Bible, which includes a parable about using God-given talent for the greater good.
It's a philosophy that has guided the 48-year-old surgeon throughout his career.
Between his active service and time in the reserve, Dr. Aguila spent 21 years in the Air Force. But the most rewarding part, he said, was his medical service in Afghanistan.
"I spent a lot of time doing head and neck reconstruction, over 300 cases," he said. "About 95% of those 300 cases were cases that we did to help the civilians there in Afghanistan -- people who would not get care otherwise."
Once out of the military, Aguila wanted to continue the medical mission work he had done in Afghanistan, so he opened Healing Hands of Nebraska, a surgical practice that strives to make operations affordable for its patients.
And although he does accept lump-sum and installment payments for procedures, his M25 program also uses a time-based billing system that counts volunteer service as payment. His clinic tabulates a reasonable price for each procedure and then determines how many community service hours would cover that cost.
"The M25 program is a mechanism by which we allow patients to invest in themselves and allows patients to judge the value for themselves," Aguila said.
What's more, the program allows patients to recruit friends, family, neighbors, and even people they've never met to accumulate the volunteer hours to "pay" for their treatments.
M25's first patient
Jeff Jensen, an entrepreneur who owns a small financial advising firm in Norfolk, Nebraska, was Dr. Aguila's first patient to pay for surgery through volunteerism with the M25 program.
A previous, botched procedure caused severe nerve damage in his foot, and left Jensen barely able to walk. While exploring options, he came across Dr. Aguila, who said the surgery would cost $12,000 or 560 hours of community service.
"We're not rich; we don't have that kind of money lying around," said Jensen. "If (volunteering) wasn't an option, I probably would have just said 'We'll deal with it and save money until we can pay for it.'"
The 52-year-old Boy Scout leader and church member got help with the hours from his scouts and his congregation, before a chance connection on Facebook led to even more volunteer hours donated on his behalf.
Kristi Brummels, a learning resource assistant with the University of Nebraska Medical Center, came across Jensen's story in a promotional video for the M25 program on Dr. Aguila's Facebook page.
Brummels coordinates volunteer experiences for nursing students, and says a light bulb went off in her head when she learned of his story.
"I immediately thought of the nursing students here," she said. "I thought it would be the perfect fit for our community service project."
Brummels and University of Nebraska nursing students collectively provided 180 hours of community service toward Jensen's surgery, along with 100 other individuals who chipped in service hours as well.
"Not one person in that nursing program knew who I was," said Jensen. "It was the kindness of strangers that got this accomplished for me."
A community ignited by volunteerism
Though the M25 program is helping patients get the treatments they need, it is also making an impact beyond Nebraska.
The Orphan Grain Train -- a volunteer network that packs and ships donated food, clothing, medical, and other needed items to people in 69 different countries, including the US -- has seen many M25 volunteers donate hours to support its work.
Grant Schmidt, vice president of Orphan Grain Train, told CNN he'd seen a renewed commitment from volunteers, who are staying involved with his organization outside of the M25 program.
"What we're seeing is people don't just walk out of here and never come back again. There's an intrinsic reward with doing an act of service for someone else," Schmidt added.
Inspired by Aguila's gesture the South Omaha Surgical Center became the first M25 partner facility to donate facility fees and staff as part of the program.
Creating a program that benefits that entire community is exactly what Aguila says he'd hoped for when he started the program.
"In my heart of hearts, I had this hope that we would rekindle in our neighbors and in ourselves a sense of volunteerism," said Aguila.
As for his patients, Aguila said the benefits extend beyond just their surgery. The community's support encourages them to be more invested in their long-term recovery, he said.
"They have the moral support of their community to help them get better, and that is shifting the way in which patients pursue their healthcare."