By Emmanuel Fashakin
On a sunny Fall day in 2001, I peered through the blinds in my practice consulting room into the waiting room and saw Phulganda waiting to see me. “Good!” I said under my breath; “maybe we will make enough money today to cover our bills.”
Phulganda was one of the earliest patients when we opened this branch, our second, on Jamaica Avenue, Richmond Hill, New York about a year earlier. Money was tight. Citibank had promised us financing for the purchase of the medical practice but they pulled out and left us in the cold midway into the transaction. No reason was given. The seller had inserted into the Commercial Real Estate Contract a clause that I would forfeit my 10% deposit if I failed to close FOR ANY REASON. Inability to obtain financing was not a valid excuse. There would be no waiver of that clause. It was a terrible situation. I raised cash from getting a second mortgage on my primary residence. But it was not enough. I was still about $35,000 short. I was able to get a personal loan of $15,000 from Advanta Bank and raised the balance wherever I could find it, mainly through cash advances from credit cards. Life was rough. We were broke like a rat in the church. Every patient visit was God-sent.
It was into the situation that Phulganda walked into that fateful morning. Phulganda (yes, that’s her real name because I am not divulging any medical info, and she has the higher moral ground here), in an earlier visit, had told me that her name means “flower” in her native Guyanese language. She was a faithful patient who kept her appointments regularly. I usually looked forward to her visit.
Phulganda came into my room and my smile vanished at once when she blurted out: “Doctor, my insurance is not working and I need to see you because I have run out of medications.” “Why don’t you go and fix it?, I asked in a low voice. “I am going to do that, Doctor,” she explained, “but I want you to prescribe my medications so I could buy them.” “You should go and fix the insurance and come back because they are not going to pay us for this visit”, I insisted. I refused to prescribe her medications because I knew that if I renewed the medications then, she would not return for several months, even if her insurance was fixed, and we needed the money. As Phulganda headed for the door, she looked back at me, and she told me, with hurt in her eyes: “Doctor, I have been one of your regular loyal patients!” That was the very last time I saw Phulganda: she never returned to the practice.
Over the years, Phulganda’s words have gnawed at my heart: “Doctor, I have been one of your regular loyal patients!” Why didn’t I at least renew her medications, even if I was not going to give her a full examination? What happened to Phulganda afterward? Was her insurance renewed and was she ok? I would never know. I never saw Phulganda again, not even in the community where I run into my patients now and then.
My failure on the Phulganda matter has caused me great anguish over the years. Why didn’t I do the needful and trust the Lord to meet our finances? We started our practice at Parsons Blvd, Flushing in 1996 from zero, sandwiched between two very hostile Asian doctors’ offices. They did everything in their power to discourage us, including taking down our signs at night, etc. But we thrived. Within nine months, one of them folded up and closed the practice. The other was just limping along, while we blossomed and flourished. So why did I withhold mercy and grace from Phulganda? I decided that I would never allow same to happen again.
Now I tell my patients with chronic conditions: “if for any reason you lose your insurance coverage, don’t stay home. Come to the office and we will do our best for you”. If patients lose their insurance or are unable to pay for any reason, I ask my staff to accept whatever the patient can afford as full and final payment. And we also see them even if they have no money to pay. In a few instances, we give them money to buy essential drugs if they fall on hard times. A patient burst into tears when I pressed a $100 bill into her hands. We send their prescriptions to where they can get them at lower prices like the local Walmart, and get them enrolled at goodrx. com to get drugs at discounted prices at other pharmacies.
Phulganda has been such a great teacher that we have now made free treatment a permanent feature at Abbydek. In 2017, we started the “FREEDOM HOUR” at our Richmond Hill location: between 3 pm and 4 pm, every Saturday, we give free consultations to all patients who are unable, unwilling, or not paying for any reason. In March 2018, one patient asked me: “you people see people free of charge on Saturdays, is this part of some Government program?” I replied: “no, it’s part of God’s Program, our service to humanity.” Our patients don’t have to pay during the Freedom Hour, because someone, Phulganda, has paid for everybody.
Emmanuel O. Fashakin, M.D
Emmanuel O. Fashakin, M.D., FMCS(Nig), FWACS, FRCS(Ed), FAAFP, Esq.
Attorney at Law & Medical Director,
Abbydek Family Medical Practice, P.C.
Web address: http://www.abbydek.com
Cell phone: +1-347-217-6175
“Primum non nocere”
