Top Family Doctors 2002: Making a Difference Philanthropy comes in many forms, and physicians are a generous bunch. We've profiled four primary-care doctors who view medicine as a service project. Delaware Today, November 2002 Hopeful Thinking: Dr. Melissa Tribuiani When the Center of Hope, an outreach effort by St. Francis Hospital, opened in 1996, it was intended to serve Newark's rising population of low-income Hispanic immigrants, whose often-transient lifestyle — moving from area to area according to where work was available — sometimes made it difficult for them to receive stable healthcare. Dr. Melissa Tribuiani, 33, the Center of Hope's current medical director, fell into her position not only because of her desire to provide care for people who desperately need it, but also because she's bilingual, as are all of the staff at the Center of Hope. Her patients are largely working-class Hispanic families who often don't have the money to pay for their healthcare. Many Mexican immigrants live in the Newark area, she says, and there's a sizeable Puerto Rican population from Wilmington who also receive care at the Center of Hope. Tribuiani's seen plenty of families who rely on the Center of Hope as a last resort for basic needs. One family that has especially touched her heart consists of a grandmother, two parents, and four children. One of the children has muscular dystrophy and uses a wheelchair. Another child has recently also been diagnosed with muscular dystrophy. The youngest child was born prematurely, at 32 weeks, and has required extra care. The family regularly showed up en masse at the Center of Hope for their extraordinary medical needs, and through these regular visits, Tribuiani saw the grandmother for hyperthyroidism, a serious condition. If the grandmother hadn't come to the Center of Hope, Tribuiani says, "she probably would have died." Treating whole families is the model family practice medicine has always tried to emulate, she says. The Center of Hope sees a high number of OB/GYN and pediatric patients, and her family-centered system means offering vaccinations for young children when mothers come in for ob/gyn care. Using this approach, Tribuiani says, "We have one of the highest immunization rates in the state." Patients have come to see the value in the Center of Hope and on most days, it can get a little frantic, she says. After opening just over five years ago, the Center of Hope may already need to expand. Tribuiani has pushed for a larger location. "Not only can we see more people, we can see more uninsured people," she says. "We can turn away the insured and send them to St. Francis, but for the uninsured people, they've got no other place to go." Delivering Care: Dr. Eileen Schmitt A year and a half ago, Eileen Schmitt zipped up the elevator each morning to the top floor of St. Francis Hospital and sat behind a polished, executive desk. On this desk, a tiny tray brimmed with a stack of business cards that read, "M. Eileen Schmitt, M.D., CEO." Nowadays, her tiny ground-floor office neighbors storage and custodial space and seems secluded. Her salary is much lower. And whereas a year and a half ago, she worked mostly among powerful administrative staff in tailored power suits, she now spends most of her time driving around the city, working among the poor. While she enjoyed her time as St. Francis's top official, when the opportunity came during the summer of 2001 to take over the hospital's St. Clare Van program, Schmitt stepped down as CEO and had no qualms about taking the elevator each morning to the ground floor. "It wasn't a hard transition," says Schmitt, 58. "Initially, when I first went into medicine, I wanted to do missionary work. I think getting back to taking care of people — especially people who don't have the means to get medical care — helps to fulfill my initial calling." Four days a week, Schmitt drives around Wilmington in the St. Clare Van, a mobile medical examination unit with two full exam rooms. The program began 10 years ago when Brother Ronald Gianonne, director of the Ministry of Caring, and Paul King, then the CEO of St. Francis, purchased the van with donations from several major contributors. Since then, the van has made stops four days a week at sites in Wilmington including the Emmanuel Dining Room, the House of Joseph and the Job Placement Center. "It's an expensive service to provide," Schmitt says. "We ask no money, we take no insurance. In fact, the only requisite to come on the van and be seen is that you have no insurance." The hospital relies on donors to help defray the costs of treatment, which can skyrocket when expensive medications are needed. Still, Schmitt has never denied services because of the costs. "A good example is a gentleman who came on the van who ended up with a brain tumor and needed immediate neurosurgery," she says. "There was never any question: he came in and had the surgery. I'm sure the bill was in the thousands." The costs become even more staggering when multiplied by the number of people Schmitt and her staff see each day. "We may pull up and there may be 20 people waiting for us," Schmitt says. "Some days we can see anywhere from 25 to 40-plus." Nearly a third of the patients are children, and Schmitt is proud that the program can offer free immunizations. She also sees an unusually high number of geriatric patients. "One would think you wouldn't see geriatrics because most older people are covered by Medicare," she says. "However, we're seeing immigrants coming from other countries, and the elderly, they're not eligible for Medicare." Partners for Life: Drs. Ethel and David Platt After legendary Delaware doctors Ethel and David Platt officially retired from family practice in July 1989, David began an outreach program called Physicians and Educators for Improved Student Health. He visited area high schools and spoke to the students about topics like teen pregnancy and alcoholism. At one of the sessions, a young man introduced him to the rest of the class. "This is Dr. Platt," he said. "He delivered me." During the 48 years Ethel and David Platt practiced family medicine in the Wilmington area, they had the opportunity to work with four generations of families, which David lists, after careful consideration, as their greatest achievement as doctors. He does not list the many boards the husband-and-wife team have sat on or the honors and recognitions — too many to name — that he and Ethel have received over the years. To both of them, the families they've treated have been the source of their second greatest joy. Their greatest joy has been their own family. The Platts married on the Sunday after David's medical school graduation in June 1941. America entered World War II six months later. David spent four years in the U.S. Army Medical Corps, emerging as a major. But apart from the time David spent in the military, all of Ethel and David's distinguished careers were spent practicing family medicine together. Physicians worked differently when the two young doctors started out together in 1946, Ethel says. Back then, she says, "If a patient needed to be seen at night ... you went out and saw them." If there was an emergency during the night, David would rush out so Ethel would have more time to spend with their son Richard, now also a physician and a professor at Harvard University. It helped that during those early years, they lived directly above their office in Wilmington. Through the years, Ethel and David kept active in the Delaware Academy of Family Physicians, at times serving in executive capacities, and upon their retirement, the academy established the Ethel and David Platt Family Practice Fellowship, which allows two medical students each year to spend several weeks shadowing a family doctor in Delaware. Local physicians have enjoyed being hosts for the program, Ethel says, and sometimes, the physician has even allowed the student to live with them during the fellowship. David, at age 88, still teaches two classes at the University of Delaware's Academy of Lifelong Learning: "Medical Ethics" and "Medical Discoveries and Current Events." Ethel and David believe strongly in philanthropy and volunteer work. In total, 146 different charities receive donations at least once a year from the Platts. After