by Jess McCuan
photo by Brent Fleury

Suzanne Landis knew at age 10 that she wanted to be a doctor like her father. In Lancaster, Pennsylvania, where she grew up, her dad worked around the clock. “I went on house calls so that I could actually see him,” she says. Often, his patients couldn’t pay, so he accepted venison or vegetables from people’s gardens in exchange for care. Landis says she learned from him that healthcare is a right and not a privilege, a belief that’s carried over into her own medical practice.
That view also carried over into a Buncombe County system that Landis helped create in 1995. Project Access, which helps low-income and uninsured patients get access to medical care, is a novel local solution to the current healthcare crisis. Basically, local doctors and hospitals agree to donate their time and services to low-income patients, and then they form a specialty referral network, sending patients to other doctors and specialists within the network for free services. In 1997, Asheville-area physicians donated $1.6 million in services to Project Access and hospitals donated  $1.4 million. In 2007, doctors donated almost $5 million in charitable care and local hospitals donated about $6.7 million.

Landis, who helped write the original grant for Project Access, says she and fellow doctors knew that some Asheville physicians were already donating care. But they had to come up with a way to formalize that process, getting free care from the right kinds of doctors to more people more efficiently. For example, before Project Access began, Landis had a low-income, uninsured patient with diabetes who Landis didn’t charge for treatment because the patient couldn’t pay. Still, the patient needed a glucometer to check her blood sugar, which she couldn’t afford, nor could she afford refills on her regular medications. Because she was embarrassed about this, says Landis, the patient wouldn’t come in unless she had an emergency—often, a diabetic foot infection. Eventually, the woman had her foot amputated. But under Project Access, the woman would have qualified for many levels of free care, including a glucometer, labs and medications, for a very small co-pay. “I could admit her to the hospital and the hospital wouldn’t bill her,” Landis says. “Her care would be as easy for me to manage as an insured patient.”

Still, it’s not a perfect system. “This is still a band-aid,” says Landis, who got a masters degree in public health after spending time working in rural health clinics in southern Florida and eastern Tennessee. “I never thought that in 2008 we would not have universal access to healthcare. I thought we would have a cogent national solution to the healthcare problem.”

The answer isn’t even in implementing Project Access-type programs in every community, she says, since ideally, doctors, like everyone else, should get paid for their work. But until someone comes up with a good large-scale solution to the nation’s healthcare woes, Project Access is helping thousands of people get care immediately. Former U.S. representative Charles Taylor nominated Landis for a Local Legend award for her work, which she modestly says was nice but not necessary. “Every day I see patients impacted by Project Access,” says Landis, whose medical office is in North Asheville. “I just feel good that I’ve been a part of it.”