Sikes
Alvin
Bill Davis
Time Magazine
 California The Single-Doctor HMO A small town dumps its provider for a rebel medic Time February 26, 2001 |
LOYALTY Davis and his patients struggle to keep the practice afloat
thing pitched in to rehab the abandoned shoe-repair shop on Main Street. On Oct. 1, with $50,000 in the kitty, the Winters Health Care Foundation was a bricks-and-mortar reality, accepting all forms of payment, including food, services, IOU's and cash, but absolutely, positively, no HMO insurance. Right here would be the perfect spot to plug in the happy ending so we could all stand up and cheer. But there is no ending yet, and in some respects this venture is a test of whether a doctor can survive without putting a dollar sign or a clock on a patient's needs. Start-up costs have put the clinic in a hole, and getting reimbursement for treatment of low-income patients with medical insurance has been a predictable nightmare. Loyal patients like Debra Ramos are paying cash, even though they have HMO insurance they could use at Sutter West. "But I don't know how long I can afford that," says Ramos. 'We are struggling right now, but I think we're about to turn a comer," says Martinez, chairman of the foundation, which still gets a trickle of contributions at 23 Main Street, Winters, Calif. 95694 (WBDavis@Davis.com). "Dr. Davis and his wife Wendy [the currently unpaid executive director of the clinic] have put it on the line for us, and we have to all pitch in and fight for them." Davis hasn't yet drawn a salary. But it was a happy doe who made a house call last week to check on chronically ill roommates Ramon Castellanos and Edwin Giezendanner. "I don't know where all this is going to lead," Davis says. "But I'm tired of doing the wrong things as a doctor. I want to do the right things for a while and just hope it works out." * | ||
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IF YOU'VE VISITED A DOCTOR anytime recently, you know the routine. You wait an hour for a 10-minute onceover, and you can't get an aspirin tablet or a Band-Aid-let alone a referral-without six bean counters and a dozen paper pushers eyeballing your entire medical history.
In the one-traffic-light Northern California town of Winters (pop. 5,300), one doctor has said no to all that. "Why in the world should you have to fill out a referral form and wait for approval when you know the approval is guaranteed?" asks Bill Davis, who got tired of treating patients as they whizzed by on the managed-care assembly line. "There's no value placed on your relationship with your patients. It's all on how much money you generate." Davis' ranting is aimed at the entire industry rather than just his ex-employer. But it made him the resident bad boy at Sutter West Medical Group, part of a health-care system |
with 5,000 physicians in Northern California. There are certain realities no doctor loves, says Sutter spokeswoman Nancy Turner. "But they pretty much live with it and accept it as the state of medicine today."
Not Davis. He was so fed up by the time he quit Sutter last June, he was prepared to get out of medicine altogether and go teach high school. But the town of Winters, which exists in another time, wouldn't let him. Davis, who had his own practice before joining Sutter in 1994, often rode through town on his bicycle to see how patients were getting on with their new crutches or responding to a change in medication. He had driven patients to the hospital and grieved with the families of the dead and dying. I can't tell you the number of times he came to my house in the middle of the night because my daughter was sick," says Debbie Hayes. And so when he walked out |
the door of his Sutter office for the last time, townsfolk were there by the dozens to thank him for taking a stand. They also swarmed meetings to figure out how to keep him. "There's a tradition of people taking care of each other in this town," says walnut rancher Joe Martinez, 53, who came up with the idea of a nonprofit
TRADITIONALIST Davis on house call
health-care foundation owned and operated by the residents of Winters. With guess who as resident physician. Several fund raisers later, they were on their way. Carpenters, electricians and anybody who knew how to do any | |
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