Dr. Dave Knows What’s Wrong With Healthcare. And How to Fix It.

10/27/2009 4:00 AM |

I am in Dr. Dave Ores’ cramped, messy waiting room at the end of a work day, sitting next to a middle-aged woman in a headscarf. A dusty vacuum occupies one corner, a paint-stained ladder another. No receptionist greets you upon entering—just a paper sign hanging on the glass door that says “The Doctor is IN”—no nurse takes your name or hands you a clipboard. Muffled voices can be heard from the adjoining room. NPR plays out of an AIWA boombox. The walls are painted a deep crimson, though the color is largely obscured by the paintings, photographs and newspaper clippings that adorn the walls: what look like gifts collected over a long career, haphazardly hung together.

After a few minutes, the doctor appears and walks a patient to the door. Then he turns to the woman. She pulls her scarf back and reveals a mole. “I’ve had it my whole life,” she says, standing by the door; it was always brown, but now it has turned red.

“It’s just a scrape,” Ores tells her, taking hardly a moment to examine it. He jokes that a gnome may have done it, and they ought to hunt it down. As she puts on sunglasses, he identifies the temple arms as the likely culprit. He opens the door for her, belaboring the gnome joke as she departs. No money was exchanged, no charts filled out.

“I’m a neighborhood country doctor,” Ores told The Villager several years ago, “in an urban setting.”

***

Patients pop into Dr. Ores’ office “all the time” for quick questions like that. (Otherwise, he sees about 20 or so patients a day, on average.) If she—a neighbor and regular patient, whom he would examine, he tells me, more thoroughly during a more formal subsequent visit—had gone to an ordinary doctor, or a clinic or a hospital, for such a potentially minor query, it would have cost hundreds of dollars (not to mention all the paperwork that would have to have been filled out and the man hours devoted). If she were lucky, if she had health insurance, such a bill might not be such a big deal. But over one million New Yorkers lack health insurance and thus can’t afford such visits. And, anyway, as Ores tells me again and again, the health insurance industry is a sham.

“It’s a national disgrace, to put it mildly,” he says. “It’s the biggest scam since the world was flat.” His favorite metaphors when discussing it are slavery and apartheid. But, as a doctor, he doesn’t just have to gripe or grind his teeth about the state of medicine. He can do something about it.

Ores, known affectionately as “Dr. Dave,” has been operating as a general practitioner (and tattoo remover!) out of his modest office on Clinton Street, on the Lower East Side, for roughly 15 years; he had an office on the corner of East Houston for about eight years before that, but his landlord did not renew his lease. (“Bars make more money,” he surmises.)

He treats anyone who walks in, regardless of insurance—in fact, he sees himself as a “conscientious objector” to the health insurance industry. A dusty sign in that blood-red waiting room lists his prices: $350 for first-timers, $250 for repeat-visitors. But, unlike most physicians, Ores doesn’t try very hard to collect outstanding balances, making him a de facto pay-what-you-can doctor. His home and office rent are low-income-each cost him less than $1,000. “That’s how I can afford to do this. If I was paying $6,000 a month, I couldn’t do this. I’m not wealthy. If I were, I’d work for free.”

5 Comment

  • the Red Cross is not a bad idea. If the public option does not pass in this upcoming bill we will definitely need a massive humanitarian effort to save us from these insurance vampires.

  • So, a doctor charges $500 a visit, because he can. The insurance negotiates it to $300. The patient pays $25. Where is the racket?

    And insurance companies don’t make money on “kids with brain cancer”. They make money on the kids who DON’T get brain cancer.

    I admire what he does for community health. But the soap box needs to go away.

  • Community MH Worker– sounds like you’ve never had to contest a claim with medical insurance, or had to watch people be refused life-saving procedures because of insurance.

    It is a racket- it wasn’t always, but it’s turned into one.

  • Rosamund- It’s ILLEGAL to refuse any life-saving medical treatment due to insurance or money. Look up EMTALA (http://www.emtala.com). This is a lie perpetrated by people who want to be inflammatory without knowing the truth.
    It’s the doctors who don’t treat because of fears of not getting paid that are criminal. And pharmaceutical companies charging outrageous amounts of money for patented drugs. And the litigious society that creates ridiculous, frivolous law suits that increase the cost of malpractice insurance for medical providers. And all the other factors that go into the stupidly high cost of medical care in the US.
    Don’t think the insurance company (at least alone) is to blame.