Doctor brings medical care to homeless in Pittsburgh

PITTSBURGH -- Nearly a decade ago, a young doctor dressed in an old shirt and torn jeans started making trips to Pittsburgh's alleys, overpasses and bridge abutments, a bag of medical supplies at the ready.

Dr. James Withers took to the streets to start one of the few programs in the country offering street-level health care to the homeless. Braving 90-degree heat, rain and snow, he has treated head colds, broken arms, pregnancies, heart attacks and maggot-infested wounds.

Withers, 44, an internist at Mercy Hospital, said he started Operation Safety Net in 1993 to get himself out of the hospital setting and fill a gap in services for the homeless, who rarely receive medical care.

"I knew there was a group that was so alienated, discouraged or whatever to go to soup kitchen or shelter clinics," Withers said. "There is this revolving door where some people are seen, they get expensive hospital care and they're released out to the street again. It is a vicious cycle."

Withers started by walking the streets with a bag of supplies he bought or scrounged, trying to dress like his patients so they would feel comfortable around him. Now 30 people, including former street patients, are involved in the program, which has a $300,000 annual budget and a converted bread truck that serves as a mobile clinic.

Because of his efforts for the homeless, Withers is one of 10 people who will be awarded $120,000 from the Robert Wood Johnson Foundation this month. He will get a $15,000 personal stipend, with the rest going toward the program.

"There are homeless health care programs all over the country now," said Cathy Dunham, director of the foundation's Community Health Leadership program. But she said the program is unusual in its outreach to people on the street.

"He has the trust of the people who have enormous health care needs but who don't trust the rest of the system. They say, 'Hey doctor, I've got this problem, why don't you take a look at it,"' she said.

Withers' program has served as a model for similar programs around the country and in Canada. He has visited and advised programs in Houston, San Diego, Toronto, New Jersey and Jacksonville, Fla.

Withers' work is not without its hazards. In the early years of the program, he recalls almost being mugged, having a shotgun pointed at him and almost being arrested by police as a burglary suspect.

"It is not a controlled environment so you have to be able to use people skills and good judgment," Withers said. "We always have a formerly homeless person with us who knows the folks and knows their potential and background."

A doctor or nurse teamed up with a former homeless person can be found on Pittsburgh's streets almost every night. Withers still makes his rounds on Mondays.

The teams are equipped with wireless devices they can use to check medical records of the 6,000 cases they've handled in the past nine years.

Mark Meyer, 36, a Pittsburgh doctor who has worked with the group since 1994, is optimistic that attending to the health needs of the city's homeless can help them get back on their feet and off the streets.

"If we can show them it matters that you are alive and that you need health care and food just like the rest of us, and you are a real legitimate person in our eyes and society, we often don't see them anymore," he said.