Shopping along 5th Avenue is a loud experience. The noise is loud, and the colors are loud.
Stores compete to display their wares as boldly as they can, often on tables that spill out onto the street. In front of wide-open storefronts or huge shop windows, hawkers beckon those hustling by.
Many stores sport the red, green and white flag of Mexico, better to entice a population that seems to be growing by the day. In La Placita on the 61st block of 5th, shoppers pick up hard-to-find items that remind them of home: dried avocado leaves, “Maizteca” brand corn tortillas straight from Mexico, jars of pickled nopales verdes–a cactus-like leaf found in warmer climes.
But one business needs no hawkers, no flamboyant visual or verbal allure. Apart from a few catchy optometrist’s displays, most of the storefront medical offices along 5th Avenue are fronted by stark black-on-white signs: “Dentist, Medicaid and All Insurance/Dentista, Medicaid y Todo Seguro,” or just “Medical Dental.”
From 45th Street to 59th Street, almost no block wants for a storefront clinic. There are 20 in all, and some blocks have as many as three clustered together. “Compared to 4th Avenue or 8th Avenue, more people come over here, more people walk around over here on 5th Avenue,” explains pediatrician Tajammal Gilani, who has been practicing at 57th Street for 11 years. As he speaks, a young mother comes in with a worried look and her infant daughter in shiny black Mary Janes and a frilly pink dress. “Fifth,” he says, “is a main shopping area.
In Sunset Park, medical care is all about shopping–window shopping.
That’s because many of the patients who use the clinics often have no referrals, no appointments, no enticement to enter a doctor’s office other than its location, an empty waiting room and the fact that it takes Medicaid.
“We have a lot of working poor in this area,” says Frank Monk, who runs an Ob-Gyn clinic in the neighborhood. “They need to be able to walk in off the street and be treated for the flu, as opposed to waiting around a hospital for hours and hours. These are people who don’t have the kind of jobs where they can take a day off to drag the kids to the doctor. It’s got to be convenient or they won’t come.
At a pediatrician’s office on 54th Street, a 28-year-old Mexican woman explains in agitated Spanish that she comes here because she was given rushed, wrong advice for her 5-year-old daughter at a city hospital. “I refused to accept their medication and their asthma pump,” says the woman, who asked that her name not be used.
The hospital’s treatment only worsened her daugher’s condition, she says. “They make serious decisions like that after very short examinations,” she adds, as her daughter bounds around the waiting room. “Since I started bringing her here, [this doctor] takes more time with her and she got better.
Getting quality health care–or any health care at all–is a big issue for Latinos. A Census Bureau study released this year revealed that 34 percent of Hispanics had no health insurance, compared with 16 percent of the overall population. Latino men have lower rates of insurance coverage than any other demographic group.
Still, only a small fraction of the patients who visit the 5th Avenue offices have no coverage at all. Most of the neighborhood’s undocumented aliens, doctors say, keep away from medical care until they are really sick, and then they head for the local emergency room.
The 5th Avenue doctors and dentists make most of their money off of Medicaid-eligible patients. But even the insured patients usually don’t show up unless someone in their families gets very ill-access to preventative check-ups and screenings is another catagory where Latinos lag far behind the national average.
This makes medical life on 5th Avenue a sort of controlled chaos. More often than not, the offices are jammed with mothers and their coughing children. People stumble in whenever there’s a crisis.
“No two days are ever the same here,” says Dr. Bernard Weitz, sitting in the optometrist’s office he shares on the 48th block of 5th Avenue. He recalls a recent Friday, when his office was called because a man working at a nearby factory had been poked in the eye with a box corner.
“I see all sorts of diseases and unusual eye conditions,” Weitz says. “That’s what makes my job extremely interesting.”
A practice on 5th can also be lucrative.
Even with recent competition from hospitals opening networks of storefront offices, the demand for the offices seems to have held steady. Renee Giordano, head of the Sunset Park Business Improvement District, reports that despite increasing rents, the number of clinics has remained pretty much constant. “A couple closed down during the last year,” she says, “and a couple opened up.”
The strip has earned a reputation in Latino New York, attracting patients from other parts of Brooklyn and Queens. “There’s a doctors’ row in Bay Ridge, there’s a doctors’ row here,” says Dr. Peter Lama, who opened his dental practice on the 61st block of 5th Avenue just a few months ago. “It’s tradition.”
The popularity of the clinics can, in part, be chalked up to the patients’ cultural frame of reference. In Latin American countries, HMOs are rare, and it’s not uncommon for primary care to consist of a trip to a local pharmacist for a handful of pills. “This neighborhood is almost like a small town,” says Dr. Louis Jablin, who has been a 5th Avenue podiatrist for nearly 19 years. “And I’m like a small-town doctor.”
More to the point, Sunset Park is one of the few neighborhoods left in New York where a doctor is still a small businessman.
Dr. Weitz, in addition to examining patients, also sells them glasses and contact lenses. When a young Mexican man in his late teens, newly arrived from Texas, comes in for an exam to update his eyeglass prescription, Weitz careens between two roles. With a baggy-jeaned friend translating, the kid asks if he can replace only one lens–so he can use the money he’ll save to afford a pair of Polo frames.
“Think about what you want,” Weitz advises. “Do you want to see or be seen?”