There is only one doctor openly prescribing medical marijuana in Brooklyn, and he’s suspiciously hard to find.
“He doesn’t work here anymore,” says the security guard at Kingsbrook Jewish Hospital, one of the hospitals where Dr. Kevin T. Custis claims to be affiliated. “You’re the fourth person to ask today.”
It’s a similar response at the second address I try—also the wrong one. “You’re looking for that one doctor,” a middle-aged woman at the door says. “I think he’s four blocks that way.”
Custis, a family physician from Baltimore, Maryland, graduated from SUNY Downstate Medical Center College of Medicine in 1996. Described as an “exemplary resident” by his professors, he didn’t make news again until last year when his name appeared in a New York Times investigation of three-quarter houses.
Three-quarter houses are unlicensed facilities where landlords make a profit by preying on vulnerable individuals like substance abusers, former felons, and the mentally ill. Instead of offering supportive services, the operators cram tenants into small living quarters and force them to go to treatment programs so they can collect Medicaid kickbacks. The situation is so dire that, in July, Mayor Bill de Blasio created a task force to investigate.
At some point, one of the most notorious of these landlords, Yury Baumlit, (the central character of the Times report), introduced a new requirement for tenants: an appointment with Dr. Custis. In the report, 17 individuals say they were taken to Custis’s clinic and “forced to undergo three to four hours of testing in order to get a bed.” Lured there by free pizza, each was allegedly paid $20 to stay. An individual named Jose Perez reported undergoing 19 different tests including “ultrasounds of cerebral arteries” to the tune of $1,700 in Medicaid dollars.
Another person said they met a man at Custis’s office who told them he was a “recruiter” who “drove a van around to find patients from shelters, churches, and welfare offices, ‘where there are people who have Medicaid and don’t have money.’” Perez guessed that was the reason for the unnecessary tests. “They get rich off all of us,” he said.
In response to the allegations, Custis told the Times that the tests were part of a clinical study he was performing with a researcher from Mt. Sinai Hospital. The hospital, when contacted, denied any involvement. The most recent clinical study published by Custis on PubMed date back to 1992.
While the Times report has prompted a major investigation of Baumlit—who, it was announced in August, is facing criminal charges—Custis, it seems, quietly kept going. Whether he’s leaving his alleged Medicaid conspiracy behind to start prescribing medical marijuana legally, or has another trick up his sleeve entirely, remains to be seen.
Next door to a Family Dollar on an otherwise empty street in Brooklyn is where I finally find Custis—or at least, his office. A navy blue awning with his name in white paint hangs above the front door, its glass concealed by metallic paper. Two large windows beside it are lined with white grates, both browning with rust.
Inside, the 24 plastic chairs that make up the waiting room are empty. It’s quiet and smells like cleaning solution. The nurses—there are many—seem kind. “He went to the hospital for an emergency with one of his patients,” one named Cathy tells me. “He’s here every day but he leaves to go do that.”
Cathy isn’t sure which hospital Custis goes to, or maybe she can’t say. No one seems to know when he’ll be back—perhaps tomorrow, they say. He doesn’t have a cellphone number or an email but she promises he’ll call.
Two days and six messages later, he still hasn’t.
On the Marijuanadoctors.com page for Custis, his practice is described as a “compassionate” place that has been providing “excellent and comprehensive primary care” to patients in Brooklyn for more than 18 years. His rate for medical marijuana patients is listed as $150 per 30-minute session, with a note that most people will need to see him at least four times before getting a prescription—so they can form a “bonafide relationship.”
The first few reviews on Marijuanadoctors.com, dated last year or older, give five stars and describe him as “friendly” and “caring.” At least two of them are written weeks before the first day that physicians in New York were even able to register as marijuana prescribers, meaning technically, no one would have visited him for that purpose yet. The more recent reviews, since the opening of New York City’s dispensaries Jan. 7, paint a different picture.
On Jan. 12 a woman named Malagos wrote:
“Drove 2 hrs for an appointment only to be told that the doctor had an emergency; no one ever called. Was evaluated by the tech or PA who stated that the follow up appointments could be skyped/ Repeated appointments, faxes and phone calls (though no one seems to ever be there to answer the phone) were ignored. I feel like my payment was stolen fraudulently [sic].”
A week earlier, Karen S. had a similar experience:
“I drove over 2 hours and 50 minutes for my appointment which was scheduled twice. They called to schedule my first appointment. When we arrived I thought I walked into the wrong place. It looked like a homeless shelter in there. On the website, the fee was $95 which changed to $55 more. On top of that, I expected since patients must pay cash in such a substantial amount I would be in a better environment surrounded by obvious drug abusers. Not patients that really need help for medical use [sic].”
In many ways, Custis’s story is the perfect example of what’s wrong with New York’s medical marijuana program.
According to the Compassionate Care Act, in order to be able to prescribe marijuana, New York doctors in good standing must complete a four-hour online course to be certified. At a cost of $249, the course includes things like potential drug interactions, dosing, and routes of administration. Karen O’Keefe, director of State Policies for the Marijuana Policy Project, says that educational tools like this are great, but should be voluntary.
As is, O’Keefe worries the test will prove a significant barrier, dissuading doctors who were—most likely—already hesistant. “Even under optimal conditions, without onerous things like this test, some doctors are reluctant,” O’Keefe tells me. “They’re risk averse and because marijuana is still illegal under federal law, they’re concerned.” Now, on top of this built-in anxiety, is an extra burden, one that she and others have called “unprecedented.”
The numbers, as predicted, are grim. As of Jan. 12, just 203 doctors have registered to prescribe medical marijuana in New York—a number that, considering the 79,000 active physicians in the state, amounts to less than 1 percent.
Even worse than the lack of participation is the lack of transparency regarding who is already involved. Most of the 22 states in the U.S. with medical marijuana programs release public lists of the doctors who are registered to prescribe. New York is not one of them. Meaning that unless a patient’s personal physician is one of the few, they’re out of luck.
Without a roadmap of the doctors they can turn to, millions of New York residents are scrambling to find other options. Marijuanadoctors.com generally has a long list of doctors in each state; in New York, it lists just four.
What’s resulted is an influx of calls to Marijuanadoctors.com from patients desperate to find more doctors. So many, apparently, that a red warning banner is now flashing across the homepage. “Attention NY Residents!” it reads. “Due to over 300 phone calls a day we are experiencing rather high hold times, please be patient with us.”
At this point, New York’s medical marijuana patients have no choice but to seek out the doctors that are public—doctors they know nothing about and are driving hours to find. With the demand far outnumbering the supply, Custis and others can charge hundreds of dollars per session, and mandate as many as visits as they want before the patient is approved.
It’s a lucrative concept for the doctors and a dangerous one for the patients, demanding they overlook potentially bad reviews, negative experiences, and alleged criminal activity in order to get treatment. Julie Netherland, director of the Office of Academic Engagement for the Drug Policy Alliance, has talked to countless patients about this conundrum and what they’re doing to fight it.
“It’s concerning,” she says of the state’s handling. “Our hope is that more physicians will come on board, but right now what we’re hearing from patients is enormous frustration and anger that they can’t access the program.” In an attempt to heavily restrict New York’s medical marijuana program, government officials seem to have done the opposite, resulting in a system that relies on doctors like Custis who run the kind of operations that the state was hoping to avoid.
“The DOH says it’s trying to prevent doctor shopping, to prevent ‘pot docs’ who are processing hundreds of patients,” Netherland says. “But because there is no public list what’s going to happen is doctors who advertise and get the word out are the ones that patients are going to gravitate towards. We’re creating the very circumstances they wanted to avoid.”
—with additional reporting by Brandy Zadrozny.