Miller Institute Offers High-Quality Medical Care for Musicians

"Like A Country Doctor In The Middle Of A Big City"

Volume CII, No. 5May, 2002

Mikael Elsila

When Howard Heller got hit by a line drive in Van Cortlandt Park and injured his left pinky two years ago, he knew he was in more trouble than most. Not only did he not have health insurance, but he needed his little finger for playing bagpipes, his principal instrument.

“Being an instrumentalist who needs my fingers, this was of great concern,” he told Allegro. “Fingerwork on the bagpipe is crucial, since we use our fingers to articulate. My finger swelled up; it looked awful.”

Heller, an 802 member who also plays French horn and viola da gamba, didn’t have enough contributions to get on the union’s health plan. And since he made much of his income playing bagpipes at weddings, he couldn’t afford to be out for long.

Luckily for him, and for all musicians in a similar dilemma, there is a solution.

Heller called Dr. Mitchell Kahn, the director of the Kathryn and Gilbert Miller Health Care Institute for Performing Artists, a program of St. Luke’s-Roosevelt Hospital Center. Founded in 1985, the Miller Institute provides sliding-scale medical care, specifically geared toward the performing arts community.

Heller had already visited the institute and had a good experience with doctors there. This time was no exception. “They immediately took me in for X-rays,” he said. “It turned out my finger wasn’t broken, which we were all happy about.”

But he had something else to celebrate as well. The visit, including all X-rays and treatment, only cost him $15.

The Miller Institute is not just for people without health insurance; 85 percent of its patients have some form of coverage, and anyone can make an appointment. And over the last decade it has been developing a reputation as one of the country’s premier centers for performance-related illness and injuries.

“When I first became director of the Miller Institute in 1998, it had been predominantly seen as a low-cost clinic,” Kahn told Allegro. “I have tried to turn it into a place where people who could afford to go anywhere would choose to come – because of the quality of the care. Our patients don’t come here only because it’s affordable. We provide services that people won’t find at other clinics. For example, we have really good therapists who are familiar with the problems of performers. If a violinist says, ‘It hurts when I play in seventh position,’ or ‘It hurts when I play on the lower strings,’ we know what that means.”

Kahn knows about music because he has been performing throughout his life. Originally a trombonist, he later played French horn and most recently has focused on violin. He currently plays in the Moderato string quartet (“because that’s the only tempo we can play”). He is also the Medical Director for the Metropolitan Opera.

His musical experience gives him a unique empathy toward musicians. In a 1997 interview with the University of Chicago Magazine, he explained some of the specific health problems they face. For vocalists, “a very minor respiratory infection – a little respiratory allergy, a little raspiness, any of those things – can prevent them from singing,” Kahn said. “The same thing is true of a slight tendonitis in the hand of a violinist. That’s because of the fine muscular control that’s required. And the difference between being at the very top and being mediocre is so small that you have to have a great deal of sensitivity in dealing with what appear to be very small illnesses, which are very large to these people.”

The Miller Institute has a voice laboratory for diagnosis of vocal conditions, a physical therapy gym with special dance floor, ballet barres and a mirrored wall, and a performance evaluation studio with a piano, harp, drums and video equipment to record performance problems and progress. The institute also owns an X-ray machine, does in-house blood tests, and is capable of helping people with long-term physical therapy. Psychotherapy is also available. Doctors even visit Broadway theaters and give flu shots to actors and musicians.

Referrals are an important component of the institute’s services. “We had a patient who needed a hip placement,” said Kahn. “He made too much money for Medicaid and he wasn’t old enough for Medicare.” He had no savings or health insurance. “It’s hugely expensive to get something like that done,” said Kahn. “We got everyone organized so that we were able to get it done for a very reasonable amount of money. The physician was willing to take 25 percent of his normal fee.”

For even more serious situations – patients suffering from AIDS or cancer, or who need open-heart surgery – the institute refers people to local hospitals, like Bellevue, where they can receive care.

Performing artists must bring in some proof of their profession to qualify for the sliding scale; playbills, programs or a union card will do. To compute the sliding scale, financial information must be provided, such as a tax return. A visit might cost as little as $10 or $15, or up to $75 or more, depending on the performer’s income. If an artist has health insurance but has a very low income, the institute might even cover the cost of the insurance co-pay.

Founded by the Miller Foundation, which also founded the Miller Theater at Columbia University, the institute is funded by a number of different grants. One funding source is the Berkowitz Foundation, founded by the family of David Berkowitz, who played in the Metropolitan Opera orchestra for 50 years. The Miller Institute is responsible for medical care for the Metropolitan Opera, the New York City Opera, the New York City Ballet, and American Ballet Theatre. Its physical therapists also provide services at seven Broadway theaters.

Ultimately, why should patients choose the Miller Institute for their care? “Patients get very good quality service; we’re very responsive,” said Kahn. “I get a little aggravated when I read about other doctors who are sitting in boutique practices charging $4,000 a year for patients to join. If patients need to call me, they can call me at night. But I get very few late-night calls, because people don’t panic – they know they can see a doctor the next day.”

Even the appearance of the facility is tailored to artists. “It doesn’t look like a clinic; we’ve made it look really nice,” Kahn said. “We play classical music in our waiting room, much of it donated by our patients.”

The treatment Howard Heller received two years ago at the Miller Institute allowed his finger to heal rapidly. He has been back on the bagpipes ever since. On April 4 he was the stage manager for a benefit bagpipe concert for the New York Police and Fire Widows’ and Children’s Fund. He continues to visit the institute, and has received routine blood tests, treatment for flu, and care for bruised ribs. He has nothing but good things to say about the care he has received there, but he has special praise for Kahn’s bedside manner. “He’s like a country doctor in the middle of a big city,” Heller said.

The Miller Institute is located at 425 West 59th Street, suite 6-A, between Ninth and Tenth avenues. The number to call for appointments is (212) 523-6200. The hours of operation are Monday-Thursday 9-7, Friday 9-5, and Saturday 9-1. No referral is necessary. Emergency walk-ins are welcome. You need to show some kind of proof that you are a performing artist, but you don’t need health insurance to receive services; fees are computed on a sliding scale based on your income as shown in your tax return. The Miller Institute also provides services to those who have health insurance. If you are covered by the union’s Plan A or B, you should know that some of the doctors at the Miller Institute are covered under the MagnaCare PPO and some aren’t. Get the name of the doctor you’re assigned to see and check with the union’s Health Benefits Plan staff first.