Dr. Gary Ratkin is aware that for patients with little money, trips to the emergency room can be debilitating even if doctors are able to diagnose and treat the ailment.
So when Ratkin, a retired oncologist, recently saw a patient at Casa de Salud, a low-cost health clinic in Midtown, he and other health-care providers tried to find a way to keep the person from having to make a costly trip to the ER.
That’s because at Casa, which focuses on Hispanic people, the providers are “dealing with a patient population that for the most part is uninsured and that, unfortunately, many times has had negative experiences with the health care system,” said Teresa Murillo, lead nurse at Casa.
It was “sort of a toss-up” as to whether the team at Casa could treat the patient safely without sending her to the ER, Murillo said. Ratkin developed a plan in which the staff would try “conservative outpatient management and have really close follow-up, with a shorter return interval than we would normally do for a similar problem. Ultimately this patient was able to stay out of the hospital.”
“Dr. Ratkin’s very careful, measured approach really does typify or exemplify looking at each patient in their context and not saying, ‘OK, well we have this blood sugar reading or this blood pressure, therefore we do X, Y or Z,’ ” Murillo said. “It’s not an algorithmic approach.”
It’s not only the staff at Casa who believes in Ratkin’s approach. He also has become a committed volunteer at the clinic — he’s there every Thursday — because he believes in its health-care model.
In 2012, he retired as a hematologist-oncologist at Barnes-Jewish and Missouri Baptist hospitals, but he wanted to continue to practice medicine in some form.
At Casa, Ratkin said, he was attracted to the fact that “we weren’t a free clinic, but we were a low-cost clinic, and we were trying to take care of patients not just for that minute but for the long run, to take care of their chronic illness, diabetes, high blood pressure.”
Ratkin, 76, a member of Congregation Shaare Emeth, spent years talking with people who had been diagnosed with cancer and became adept at relating to patients who might otherwise feel intimidated in those situations.
“Over the years, I have paid more and more attention to not just the scientific and medical issues, but also to the nuances of communication,” he said. “I was frequently dealing with what we call ‘bad news.’ … I was dealing with cancer patients and patients with blood disorders that did not always have a happy outcome, and so I learned how to do that in a way that I felt like I had done a good job, and I was gratified to have patients and their family members come back to me and say to me, ‘We really appreciate your saying something in this particular way.’ ”
Ratkin also had long paid attention to the problems Hispanic immigrants face in the United States. He spent most of the first two decades of his life in Texas along the border with Mexico. He recalls that when he was 10 years old, the U.S. Border Patrol picked up a woman who was cleaning his family’s house. He had gotten to know her, but she was deported and he never saw her again.
Once he became a doctor and learned how the medical system operates in the United States, he developed empathy for immigrants’ “problems of access to care.”
“In my mind, I always sort of questioned what I could do about it because I wasn’t living on the border by the time I was a physician practicing medicine,” Ratkin said. “[At Casa,] I had an opportunity to participate in providing health care to Hispanic immigrants.”
The clinic, which operates on a $1.6 million annual budget, saw more than 2,000 patients in fiscal year 2018, according to an annual report.
Ruth Terry Vilches, community engagement coordinator at Casa, said:
“Dr. Ratkin is, first of all, faithfully committed, and I don’t want to undervalue that by any means because so much of operating a volunteer model in a health care environment is you need committed people who are consistently coming and seeing patients so that patients get the same level of care that they would be getting elsewhere.
“As a medical director, he provides good input on what he thinks is working well, what’s not working well and helps provide some of that vision for the broader health clinic while still being on the ground with patients.”
She recalls an instance when a patient was nervous about seeing a male health-care provider. The staff mentioned it to Ratkin, who then went to talk with the patient “in a safe, nonthreatening environment” before seeing her in the exam room.
“That was one example of his willingness to provide culturally responsive care, recognizing that because of some of the patient’s cultural background, it might have been uncomfortable for them to be with a male physician,” Vilches said.
In addition to his work at Casa, Ratkin also volunteers with Ready Readers, a program in which he reads to preschool children in low-income communities; at the Harvey Kornblum Jewish Food Pantry; the Jewish Community Center’s Garden of Eden, which provides fresh produce to the food pantry; and as a guide of historic architecture in St. Louis.
“Just as a person, Gary is a very kind, thoughtful, gentle person,” said Leanne Schneider, a friend and fellow member of Shaare Emeth. “He listens to you.”
Family: Married to Marilyn Ratkin, father of two daughters, grandfather of five
Home: Creve Coeur
Fun Fact: Has run in most big cities around the United States and ran the New York City Marathon