Deserving Patients Within Our Borders

During the past several years, I and some other doctors I know have moved our practices away from Downtown Memphis. There are many reasons for this: having a shorter commute, establishing a presence at one hospital and searching for a better payer-mix of insured patients.

It is a modern-day reality that doctors and hospitals tend to migrate to where there are better payments -- not where there is greater need for their services.

Yet, there remains a group of doctors who carve and shape their practice not by the insurance profile of the region, but by the needs of the people. These doctors are not deterred by language and cultural barriers, famine, scarcity of medical resources, or even war.

Such is the work of Dr. Bernard Kouchner, the co-founder of Doctors Without Borders/Medecins Sans Frontieres (MSF). He is the recipient of the 1999 Nobel Peace Prize and a National Freedom Award here on Oct. 17.

Patients in the Third World and victims of disaster are not the only ones in dire need of medical help. In America today, millions are unserved or underserved by the healthcare system and by society.

Millions of inner-city mothers and children, the frail and elderly, as well as the uninsured, lack the necessary healthcare. They are victims of decisions made by society and health policies, not just by individual doctors and hospitals.

No doubt, at community clinics, such as those of the Health Department, The Church Health Center and Christ Community Health Services, volunteer doctors and nurses address some of the needs of the underserved.

No doubt, that 25 percent of my and my fellow doctors' practices are charity or underinsured care. Yet, this is a mere Band-Aid, when you look at the actual medical requirements of this section of society.

The infant mortality rate in Memphis is 14 for every 1,000 live births, which is among the highest in the nation and twice the national average. Incidence of HIV among African-American women is climbing steadily. The ranks of uninsured in America has increased to 43 million -- or 1 of every 6 Americans.

Surely, the underserved are not undeserved. The ultimate service that doctors and society can make is to provide for those who are left unserved because of policies, priorities and decisions in which they have no say. And there is a need for this kind of medical attention right within our own borders.

For me, that is a lesson that Dr. Bernard Kouchner brought to Memphis.

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