Barbara Carter is an employer’s dream: cheerful, articulate, steady. She has had the same job for seven years, working from 8 am to 1pm in the bookstore and coffee shop of Criswell College in Dallas. As assistant to the manager, she runs the cash register, helps serve food, and enjoys daily contact with the college students who are her regular customers.

But Ms. Carter is in a bind that is prevalent for the working poor. Because she works part time, her employer doesn’t provide health insurance. She doesn’t make enough money to afford a policy on her own.


And she makes too much money to qualify for government assistance. Add to this a couple of chronic conditions and multiply these patients by 500,000, and you have an accurate depiction of the healthcare crisis in Dallas County.

But Barbara Carter counts herself among the fortunate. First she found Central Dallas Ministries’ Community Health Clinic. Then Project Access found her. Ms. Carter arrived at Project Access via the hypertension clinic at CDM in East Dallas. "My blood pressure was something like 200-plus over 180," she says. "I was in stroke territory." In the course of treating her hypertension, family practitioner Maura L. Thielen, MD, noticed an abscess under Ms. Carter’s arm. She had been suffering with the condition on and off for more than two decades and had developed her own ways of coping.

"I had boils, and I had to have them lanced every three or four months," Ms. Carter says. "I would slap on a bandage to deal with the continual draining, and I popped a lot of Advil to deal with the pain." She also went to the emergency room at Parkland when the pain or discomfort became overwhelming. "Sometimes I waited through two or three shifts to be seen," Ms. Carter recalls. Finally, Dr. Thielen sent Ms. Carter to Baylor, where her condition was diagnosed as hidradenitis suppurativa, a chronic inflammation of the apocrine sweat glands. She needed to see a dermatologist. But she couldn’t really afford one.

"I don’t have health insurance," she says. "I get paid twice a month, and every cent goes toward some bill." At the time of diagnosis, the Project Access pilot program was getting underway through the CDM Community Health Clinic. Ms. Carter was referred to Project Access, where community health worker Helen Rodriguez processed her application and referred her to a Project Access dermatologist. In April, Ms. Carter made her first visit to George A. Wooming, MD.

Ms. Carter gives high marks to both Ms. Rodriguez and Dr. Wooming. "Helen was great," she says. "She wanted me to get used to making my own appointments. She even offered to take me to the doctor, but I’m used to the bus." Ms. Carter describes Dr. Wooming as "a godsend." On her first visit to his office at Medical City Dallas Hospital, Dr. Wooming gave Ms. Carter a hydrocortisone injection and antibiotics. The first injection was frightening and painful. "I didn’t want to be such a wuss," Ms. Carter says, "but I told him it was hurting and burning." Dr. Wooming put her at ease and even brought in a fan to make her more comfortable.

Ms. Carter has seen Dr. Wooming several times and feels she has regained control of both her condition and her life. "He gives me shots and antibiotics, and we keep it under control," she says. "My abscess was painful, but now I can manage it. I can move around more and I get out more. My outlook has brightened, because I’m not just sitting around trying to cope.

"I’m so proud of myself for coming to Project Access," Ms. Carter says. "I can’t afford to miss much work, and I’m just so happy not to be taking so much medication and not being in so much pain."

This year Ms. Carter took her first vacation in a long time, visiting her daughter and granddaughter in Florida. Her confidence is renewed now that she is getting the kind of personal attention and care that those with health insurance take for granted. And she is quick to give credit where credit is due. "At other clinics, you’re just a number," she says, noting that Dr. Wooming’s staff is friendly and treats her with respect. "Here at Project Access, they know who I am."