Doctor has prescription to expand health services

Expanded medical services for Island residents could be in the works, according to Dr. Nathanael Desire.

Dr. Desire and his wife, Dr. Anthonette Desire, established their practice here five years ago, but only on a limited basis. That set him to thinking “outside the box” about a plan to expand both hours and services by forming a non-profit group of doctors, physician assistants, nurses and a nutritionist who could serve the Island’s population.

In addition, other health care consultants could step in as needed to supplement the regular medical workforce explained Dr. Desire in a six-page proposal submitted to Supervisor Gary Gerth.

“The establishment of a nonprofit medical clinic will help provide the services that are needed locally,” he wrote in a letter to Mr. Gerth. “We are in the process of setting up The Shelter Island Primary Care & Health Education Center as a nonprofit that will be opened daily and adequately staffed to provide comprehensive primary medical care, radiological services, nutritional services, nutritional education, access to specialists, ancillary services and after-hour phone availability.”

“The Island has a need, but it’s hard to sustain a private office year round,” Dr. Desire said, noting that his plan would combine primary care with health education and be comprised of a staff of “highly qualified individuals who are well respected in their profession.”

Mr. Gerth has been driving the effort to improve medical services on the Island and in the past, has spoken to both Dr. Desire and Dr. Peter Kelt, who operates the Island’s only other medical office, about making this happen. Mr. Gerth also secured an agreement with NYU Winthrop (the medical group with which Dr. Kelt is affiliated) to provide medical coverage on the Island five days a week, either by Dr. Kelt or another medical professional.

But recently, Dr. Kelt was on vacation and the office was closed. Both Mr. Gerth and the Reporter contacted Winthrop about the situation and a physician’s assistant (PA) was assigned to the location. That PA was subsequently offered a $40,000 incentive to take a job elsewhere and has left the position, according to Mr. Gerth.

In a recent conversation with a Winthrop spokesperson, the Reporter learned that as of April 1, a PA will be assigned to Dr. Kelt’s office to cover any week days he doesn’t work. But Dr. Desire’s plan for a medical center, which Mr. Gerth called “very interesting,” could provide a better long-term solution.

This is not the first time Dr. Desire has ventured into medical entrepreneurship, having opened several medical-related businesses including Executive VIP Medical Services and NAD Medical Services. He also serves on the Infectious Disease Committee at Brookhaven Memorial Hospital and is a member of the American Geriatric Society, the American Board of Post-Acute and Long-term Medicine and the American Osteopathic Association.

In a meeting with Dr. Desire last Friday, he told the Reporter he was already starting to put pieces into place to get his idea off the ground. The estimated cost of the medical center plan is $1.175 million and Dr. Desire would look for a $1 million investment from the town. He believes another $75,000 can be raised in contributions and an additional $100,000 would result from payments from private patients.

He called the cost “reasonable for the unprecedented access to health care year round.”
Dr. Desire said that the center could treat several health conditions — from hypertension, heart failure and angina to diabetes, asthma, COPD, depression, back pain, arthritis and thyroid disorders. Also available would be ancillary services like radiology, nutrition, EKGs, immunizations and even house calls for seniors or housebound residents.

More expensive tests such as MRIs aren’t something he expects the medical center could handle itself, but Dr. Desire believes he could entice some specialists to schedule appointments on the Island. On the education side, he wants to work with local students interested in pursuing careers in medicine. He also wants to encourage young people to take good care of themselves while building their knowledge about physical, mental, emotional and social health.

“We hope to motivate students to improve and maintain their health, prevent disease and reduce risky behaviors,” Dr. Desire said.

He has already spent a great deal of time at the Senior Center and wants to hold regular lectures for senior citizens and other residents on topics such as tick-related diseases, disease prevention and management, drug and alcohol abuse, diet and nutrition and men’s and women’s health issues.

“I’m willing to be an integral part of the team that can make this happen,” Dr. Desire said.