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The parking lot at Durham's Lincoln Community Health Center fills quickly on a weekday morning, as cars, taxis, and shuttle buses jockey for space. Boarded-up houses and junked cars pockmark the surrounding neighborhood, where the poverty rate is clearly much higher than the 15 percent countywide. But inside the center, the mood is upbeat, and the lobby and halls teem with activity. Elderly women talk with young mothers, men swap jokes, and children watch videos and play games as they wait to be seen. The physicians and nurses in Lincoln's various clinics appear to feed off the energy, speaking a rapid-fire mix of English and Spanish as they move in seemingly synchronized fashion to address patient needs quickly and efficiently.
Far from the action, in a cramped basement office filled with medical journals, bulging file folders, and stuffed animals from her days as a pediatrician, center director Evelyn Schmidt '47, M.D. '51 has been working for hours on proposals to keep federal, state, and local funds flowing to Lincoln so the activity upstairs doesn't stall. "When you have a mission, the bottom line is just one of your concerns," she says.
For almost four decades, the mission shared by Schmidt and Lincoln has been to break through the often grim landscape facing Durham's underclass. The center provides thousands of people with primary medical care that they otherwise couldn't afford—many wouldn't even bother to seek it because of the cost. Of the more than 34,000 people who were treated at the center last year, for example, almost 85 percent lived below the poverty line and three-quarters had no health insurance.
"The general public doesn't recognize the quality of care Lincoln provides because of who they serve there," says Joyce Nichols, who has used the center for her health-care needs for thirty-five years. "The people there don't care how you're dressed or how you look or smell. They treat you with respect, and they treat you as well as or better than any other medical provider in town."
Schmidt makes sure of that. Lincoln's chief executive since shortly after it opened in 1970, she possesses a commitment to serving the poor that borders on a passion and has become the center's guiding principle in a continually changing health-care industry. Although she and her staff readily adjust to the times—Schmidt's office door features a picture of a dinosaur with the caption "Adapt or Die"—providing high-quality medical care to patients on the margins of society is the steady foundation of the center.
"Most of our patients have been pretty much left out in the cold by the health-care system," she says. "The only way we're going to succeed as a nation is if we're healthier and better educated—and I mean everybody has to be provided for." Durham, she says, is "a tale of two cities," with Duke Medical Center's world-class facilities and pioneering research taking place a stone's throw from the bleak financial and social conditions faced by Lincoln's clientele.
Under Schmidt's leadership, Lincoln has become one of the most respected health centers in the country. Amy Simmons Farber, communications director for the National Association of Community Health Centers, says Lincoln is "way ahead of the curve" on setting standards for care and implementing new technology, such as transferring paper medical records to computer and using a robotic dispenser to fill prescriptions. In 2006, Lincoln celebrated Independence Day by becoming the nation's first health center to go tobacco-free, a move that many hospitals—including Duke's—have since copied.
"They're one of the bright stars of health care," Farber says of Lincoln, adding that Schmidt makes so many trips to Capitol Hill to lobby for more funding for health centers nationwide, including the federal dollars that make up almost a quarter of Lincoln's $18 million annual budget, that she is on a first-name basis with every member of North Carolina's Congressional delegation.
"Evie is the Mother Teresa of Durham," says Fred Johnson, deputy director of the Division of Community Health at Duke Medical Center, who oversees two neighborhood medical clinics that serve as Lincoln satellites. "Lincoln is her life, and she just lives and breathes caring for the poor."
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