MIAMI - Dr. Pedro Jose Greer stands in a cool, dim operating room at Miami's Mercy Hospital, looking at a glowing image of a patient's digestive system on a flat-screen TV.
Greer is a gastroenterologist, and the patient lying on the treatment table has a potentially dangerous cauliflower-like growth on the lining of her colon. The patient's name is Nora Turcios, a 45-year-old woman with a family history of cancer.
"That's a polyp right there," Greer says, more to himself than to any of the three nurses in the room. During the 15-minute-long colonoscopy, he snips off part of the mass for a cancer biopsy and then reviews Turcios' paperwork.
Turcios, a housekeeper, doesn't have health insurance. Not important, shrugs Greer.
Greer, known to his patients as "Dr. Joe," tells them all: If they lose their insurance while under his care, that's okay - he'll continue to treat them, regardless of how much, or little, they can pay.
"When did it become acceptable in my profession," says the 53-year-old physician, "to say 'No' to somebody because they have no money?"
It's that attitude that led to Greer's recent honor: the 2009 Presidential Medal of Freedom. He was given the award in August because he cares for the poor with dignity.
In 1984, Greer founded the Camillus Health Concern, a Miami clinic providing medical care to more than 10,000 homeless and low-income patients annually. He also founded the St. John Bosco clinic, which treats low-income and immigrant patients in Miami's Little Havana neighborhood.
His latest effort is academic: Greer is now the assistant dean of academic affairs at Florida International University's new medical school, where he stresses the need for ethics in medicine.
As one would expect, Greer has strong thoughts on revamping the nation's health care system.
"Maybe," he says, "if we took care of everybody we wouldn't need reform."
For decades, the Miami physician has treated the neediest people even though it would have been easier to earn big money as a top specialist.
"You fight for what you need to do," he says. "The poor happen to be our sickest. They deserve our undivided attention."
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In 1984, Greer, then 28, was an intern at Jackson Memorial Hospital, the hospital where he was born.
One day, firefighters brought a patient they had picked up on the street into the ER. The homeless man, who later died, had tuberculosis. Greer was shocked. "Tuberculosis? In this day and age?"
After visiting a local homeless shelter, Greer began volunteering, treating patients two nights a week.
"In America, it seemed as if we didn't care if you suffered, but if you were about to die, we'd scramble to save you at (the hospital) - and then send you back to suffer, to the streets," Greer wrote in Waking Up In America, a book he published in 1999.
Soon after he started at Jackson Memorial, he walked into the office of Alina Perez-Stable, a hospital social worker.
"I want to do something about the homeless," he said.
Said Perez-Stable: "He exuded a genuineness, a passion. He identified a problem and he was going to try to solve it."
Greer and Perez-Stable founded the Camillus Health Concern, the first South Florida clinic to treat only homeless people.
Greer soon realized that he was seeing only a fraction of Miami's street people in the shelter, so he eventually went to where they lived: the Mudflats, an encampment under an Interstate 95 overpass. Using a mix of compassion and wisecracks, Greer got to know the homeless and their problems.
In the single-room clinic's first year, Greer saw 500 patients. Nearly 10 years later, the clinic - which was the first of its kind in the United States - had 30,000 visits from patients, nearly all of them homeless.
Today, there are about the same number of homeless people as then, but, thanks to Greer, they at least have a larger health clinic.
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During the Clinton administration, Greer served on a Presidential Health Professional Review Group charged with studying health care policy. It didn't go well.
"I gradually realized my presence there would have no impact," Greer later wrote. "Too often the most critical facts never made it to the discussion table because the seats around the table were taken up by influence and money."
Dismayed that "the cards were stacked in favor of the HMOs and the for-profits," he quit. That experience has kept him from helping President Barack Obama's administration during the health reform debate.
Even after receiving the Medal of Freedom from Obama in August, Greer doesn't mince words when discussing insurance companies' impact on U.S. health care.
"I do get outraged," he says. "Is it acceptable when an insurance company refuses someone for a pre-existing condition? Where in hell is that acceptable? Hell is going to be filled with insurance people. I hope they enjoy all the money they're making."