At the heart of the Shepherd’s Clinic in Baltimore is a group of doctors who donate their time and talents to help patients who have no health insurance. Annie Umbricht, M.D., who has dual appointments in internal medicine and psychiatry and behavioral sciences at the Johns Hopkins University School of Medicine, has been donating her services weekly since 2002.
“She’s truly an advocate for patient care and believes economic circumstances shouldn’t determine the level of health care you receive,” says Adongo Matthews, Shepherd’s Clinic executive director.
“Annie is relentless in her pursuit of bettering the lives of the people of Baltimore,” adds Kathleen McHugh, Shepherd’s Clinic medical director. “She is a gifted doctor who provides outstanding clinical care. She is also a kind, humble colleague who regularly reaches beyond accepted clinical duties to make her patients’ lives less burdensome, healthier and happier.”
Shepherd’s Clinic provides free health care in nine ZIP codes scattered throughout Baltimore for people who are uninsured. Patients are asked to donate $3 to $9 at the time of visit if possible.
The clinic is a Johns Hopkins Neighborhood Fund grant recipient for fiscal years 2020 and 2021.The fund was created in 2007 to support nonprofit organizations that both serve the communities near Johns Hopkins campuses and are associated with Johns Hopkins through employee or institutional involvement. The Neighborhood Fund uses pledge donations made through the United Way campaign to help local nonprofit organizations build stronger neighborhoods by addressing needs regarding community revitalization, education, employment, health and public safety. The Wilmer Eye Institute at Johns Hopkins provides free annual retinal screenings for Shepherd’s Clinic patients who have diabetes.
Umbricht calls the Shepherd’s Clinic “an oasis in medicine.”
“There are no restrictions on how long we can spend with the patients,” she says. “I can do what I think is right. Most of our cases are complex patients, and 15 minutes just does not allow you to respond to their many needs. I can address the patient’s concerns and also provide integrative practices to reduce stress and its adverse consequences on health.”
Umbricht says having the Joy Wellness Center under the same roof as the Shepherd’s Clinic helps her reinforce what she teaches the patients. The center holds group meetings to enhance patient medical care, and community members can take classes in healing arts, nutrition, yoga, diabetes management, massage, acupuncture and meditation.
“We realize that we can treat hypertension and diabetes, but if we do not simultaneously address the ‘whole person’ — our patient’s mental health, nutrition and well-being — our mission will fail,” McHugh says.
The clinic’s mission spoke to Umbricht, who deeply believes in treating the whole body. Umbricht says it is so important to take the time to notice if a patient has stooped shoulders or an inability to look her in the eyes.
“As you go through the patient’s history, you’ll uncover trauma and explanations why that patient is not blooming,” she says. “There’s an interconnectedness between breathing patterns and stress. We can help treat panic disorders and anxiety if we teach people to breathe more slowly. A typical reaction of stress is the flight or fight response. The body gets ready to run and a patient accelerates his or her breathing. It creates an imbalance and can have tremendous health implications. I often suggest patients to try slow abdominal breathing at home twice a day for 17 minutes. It’s relaxing and pretty effective in reducing a number of symptoms.”
Despite the tools Umbricht provides, challenges are intrinsic to Shepherd’s Clinic’s clientele. Some patients may make only a few dollars above the financial limit to get medical assistance. Some patients cannot come back for follow-up appointments because of transportation issues or the inability to take off work. She also sees patients who are stressed because they are unable to afford medications, although the clinic tries to minimize such issues.
The clinic’s goal is for patients to receive the same overall care and medications as patients who have health insurance.
“The Shepherd’s team all links together to find resources to help those patients. Everyone is doing their utmost to meet our patients’ needs. A cancer diagnosis can threaten a patient’s earning potential and their ability to pay rent. If those patients and their families become homeless, who is winning? We’re dealing with social issues that should not be in the richest country in the world,” Umbricht says.
Luke Bonanni, Shepherd’s Clinic patient intake administrator, recalls an appointment that illustrates Umbricht’s commitment to caring for her patients.
“A patient came into the clinic from an Emergency Room for cardiac issues,” he says. “The appointment with Dr. Umbricht was only supposed to last an hour but it went on for two.”
Bonanni says Umbricht determined that the patient’s cardiac issues were likely panic attacks brought on by many social difficulties. She gave the patient a large list of Baltimore resources, including information about rent assistance and reference to the Joy Wellness Center.
“The patient came in with low spirits but by the end, Dr. Umbricht had set her up to make real progress and over months, we saw that progress realized,” Bonanni says. “Dr. Umbricht showed me that the physical health of the patient is intrinsically linked with mental, emotional and spiritual wellbeing. Those patients that involve themselves in other services often end up managing their life outcomes better.”
“It would be amazing if more people had an outlook like hers,” adds clinic manager Michele McComas. “She doesn’t treat people like a number; she treats them like human beings.”