Dr. Evelyn Schmidt is leading the way, any tour of the Lincoln Community Health Center in East Durham will be an educational experience. The tour will wind through the center's various clinics, past its smiling nurses and medical technicians and its stark, utilitarian examination rooms. You'll see bands of mostly poor, mostly uninsured folks sitting in gray waiting room chairs. There will be children hopping about and pregnant women rubbing their bellies. The tour will be brisk, for Schmidt, the center's executive director, is fleet of foot--a five-foot dynamo striding through the halls. And she talks even faster than she walks, especially when she's advocating for her patients.
The tour might end in a big room on the center's first floor, where portraits and photographs line the walls. Schmidt will tell you how each depicted nurse, founder, board member or doctor helped make the center what it is today: a model for the way health care can and should be delivered to the poor. Despite all that, you'll have missed something essential. Tireless, devoted and modest, Schmidt won't tell you how her own leadership over the last 34 years has shaped Lincoln into the exemplar it is. She'd rather give others the credit. Consider this profile the tour's supplementary material.
The Lincoln Community Health Center is a publicly and privately funded primary health care facility that offers a wide range of services to a mostly uninsured population. Its roots go back to Lincoln Hospital, where blacks in Durham went for health care during the days of segregation. Today, most Lincoln patients are still black; 58 percent of the 31,000 served last fiscal year were African American. Thirty percent were Hispanic. Of all patients served, 83 percent were at or below the poverty level, and 80 percent were uninsured. Many of them have chronic illnesses that grew from years of inadequate health care.
"Durham is a tale of two cities," says Schmidt. "You could come to Durham and think that everybody lives in beautiful homes. You would never know there is poverty here."
A pediatrician by training, Schmidt, or Evy, as she's affectionately known, is a New Jersey native who went to Duke for her undergraduate and medical degrees. When she graduated in the 1950s, she thought, "Thank you for a very good education, but I don't like your social and political philosophy." She left the Jim Crow South and eventually ended up in New York working for the health department when she wasn't practicing pediatrics at hospitals that served low-income, mixed populations. Twenty years passed before she returned to Durham to become Lincoln Community Health Center's first (and only) executive director.
"I'm back in Durham on the other side of the street," she says.
Since 1971, Schmidt has led Lincoln's staff through numerous changes in Durham's health-care landscape. In the 1990s, the growth and transformation of many North Carolina metropolitan areas attracted droves of laborers from Mexico, most of them poor and uninsured. Today, federal spending for the uninsured is not keeping pace with the growing number of uninsured people. But still, Schmidt says, "You cannot turn away people who are sick."
Over the years, Schmidt has had the business savvy needed to increase medical services despite tightening budget constraints. She's navigated the bureaucracy of local health and medical care agencies to secure support. And she has stayed abreast of legislation and lobbied for adequate health-care policies at all levels of government.
"I am a patient, so I can speak firsthand to the resources that are available to the community," says Durham City Council member Howard Clement. "Evy has this contagious spirit that she manifests. Health care is a right, not a privilege. She makes sure that all of the staff, the doctors, the nurses and the health-care personnel are infused with that spirit."
Perhaps nothing better exhibits that spirit--the belief that health-care is a human right--than Lincoln's response to North Carolina's booming Latino population. Schmidt was at the forefront of the movement to assure that the mostly Mexican workers had adequate health care.
"In '97 or '98, I had a conversation, initiated by her, about how we could be more responsive to the needs of the community," says Ivan Parra, the former executive director of El Centro Hispano. "She was very in tune early on for the need to have bilingual personnel and the need to collaborate with community organizations." Andrea Bazan Manson, former director of El Pueblo, would agree. "If you walk into Lincoln today, you see a complete integration of Latino culture, from the waiting room to the health-care providers learning about cultural beliefs."
That kind of service is only part of Schmidt's commitment to her patients. She's an ardent spokesperson at local board meetings. She advocates for her patients with government officials. And she helps to design health-care policy.
"Through Durham Health Partners, we're working with Dr. Schmidt and other community leaders to come up with a model that will provide specialty care to folks that are served by Lincoln," says Gail Harris, assistant director of the Durham County Health Department. "And then maybe that can be rolled into other parts of the community." She adds, "We're looking for a sustainable system."
Schmidt's idea of a sustainable system is nothing new: "What this country needs is a universal health insurance that ensures that everyone can get inclusive primary health care," she says. She regularly argues that case in the nation's capital.
"Evy Schmidt is not narrowly focused on community health centers," says Fourth District Congressman David Price. "She is a passionate advocate for these centers, but she is also a passionate advocate for good health care and good access to health care. So when you sit down and talk with her, you're just as likely to talk about Medicaid and the uninsured as you are about community health centers and their direct needs." He adds, "She is certainly someone who has exercised national leadership. She's well known and respected here in Washington."
After all these years, Schmidt shows no signs of slowing down. With the center facing a budget deficit, now is not the time. "I've been at Lincoln since it opened, and I don't think I've ever been quite as worried," she says. The center faces a budget deficit. "The thing that we're faced with is whether or not we can maintain all services."
On that tour of Lincoln Community Health Center, there's something else that Schmidt might show you. In her office, amid the clutter of budget analyses, stacks of medical texts, giant stuffed animals and pictures of puppies, she keeps a 3x5 index card with a Martin Luther King quote scribbled in her own handwriting. It reads, "Of all the forms of inequality, injustice in health care is the most shocking and inhuman." In those words, there's a clue to what drives Dr. Evelyn Schmidt. How can such injustice occur in Durham, the City of Medicine? We should be able to call it the City of Health, she says. With efforts like hers, there's a chance we will.
For more information on Lincoln Community Health Center, visit www.lincolnchc.org.