Thursday, August 13, 2009

Miami's Physician to the Poor Receives Presidential Medal of Freedom

Last night, President Obama awarded the Presidential Medal of Freedom to 16 worthy individuals covering a spectrum of professions, age, race and ethnicity, but the one we want to focus on is Dr. Pedro José Greer, Jr., a Cuban-American physician who has devoted his career to caring for poor, homeless and often undocumented patients in Miami. Greer is currently Assistant Dean of Academic Affairs and Chair of the Department of Humanities, Health and Society at the Florida International University School of Medicine. He is founder of the Camillus Health Concern, a Catholic charity sponsored by the Little Brothers of the Good Shepherd that provides services to 10,000 poor and homeless patients a year in Miami-Dade County, and the St. John Bosco Clinic, which provides basic primary medical care to disadvantaged adults and children and gets 7,000 visits a year first in Little Havana and now in the Wynwood area.

The Medal of Freedom is the latest of many honors Greer has received over his professional lifetime, including a McArthur "genius grant" (1993) and three Papal Medals from the Vatican. Dr. Greer is also the author of a 1999 autobiography called Waking Up in America: How One Doctor Brings Hope to Those Who Need It Most.

U.S. Rep. Kendrick Meek, D-Miami, applauded the award. "Dr. Greer's compassion is boundless. His life mission is dedicated to the service of others, and without Dr. Greer, thousands of individuals in my district would be left without medical care and basic services," Meek said in a statement.

As our country's leaders debate the future of health care in America, perhaps it would be helpful for them to reflect on this dedicated healer's perspective as expressed in PBS's program "Who Cares: Chronic Illness in America":

To be a physician, to heal the sick, to serve the infirmed, it all seemed so simple and straightforward. A son of a physician, I knew about the emergencies, the days we couldn't be with Dad because he was tending to the ill, the Christmas mornings that were cut short by a phone call from the hospital, the long days and nights; that was all OK, for those sacrifices were for the benefit of the patient. I entered medical school with those memories in tow and the simple desire to save the world. To treat the sick, to serve all kind would be an honor; the world was mine to make better.

I trained to become an Internist, Gastroenterologist and Hepatologist. I worked with the poor, homeless and undocumented in Miami, setting up clinics in the heart of the city. I left the university and went to work in private practice with my mentor, my father. It would be easy, I thought. Treat all people, rich or poor, insured or not.

BAM!!! Healthcare reform explodes on America with hope and possibly a way to a healthier nation. Well, it brought change, just in the wrong direction -- 33 million uninsured in 1992, 44 million in 2001, and those with insurance today have less coverage than before. From a policy perspective, the wrong question was asked: "How do we make healthcare cheaper?" The question should have been "How do we make those living in our great nation healthier?" America's elderly really suffered, as evidenced by current debate on prescription drug coverage and the inability of the health system to effectively address the challenges of chronic illnesses. Paradoxically, as our population grows older, requiring more time and support from health care providers, the elderly are being dropped by both large and small HMO programs.

The job of a physician in the new millennium is not simply to battle the illnesses of patients but also to navigate a system that makes it difficult to diagnose or treat the patient. The lack of support systems for patients, the hassle of diagnostic testing for the patient, the referrals, the authorizations, and the denials that so often follow are the simplest examples of America's medical system today.

As a physician, I see and feel the problems our insured patients have; we hire more staff, one for referrals and authorizations, another to deal with all the different formularies HMOs have, and install more phone lines to deal with all the patients' hassles. To top it off, we have less time to spend with our patients - time that is invaluable for making diagnoses and building relationships with patients and their families, time for explaining, consoling, or just reassuring. These problems are multiplied ten fold for the uninsured, the majority of whom are employed and still without health insurance. Something is wrong and we need to right it.

Well, I took an oath and will honor it, for it is a privilege to treat the sick and an honor to work with the poor. My undergraduate education, medical school, post-doctoral training and fellowships should be applied to patient care and healing, not to traversing the obstacles presented by our health care system. Let us fight for the patients, be smart enough to prepare for the onslaught of chronic illnesses that this country has to deal with, and treat all our patients with dignity - let's just do it right.

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