Alums realize dream of place that helps to keep all children well

Tucked away in the corner of a Lewisville strip mall, PediPlace doesn't stand out much from the other tenants.

It has a simple storefront look, with a plain white sign and darkened windows. Open the door, however, and you've stepped into a large pediatric clinic, with cheerful wallpaper and a welcoming waiting room - as clean and inviting as any of the private pediatric practices in southern Denton County.

PediPlace - a not-for-profit clinic serving uninsured and underinsured children - is different, in a good way, from the typical pediatrician's office. It is a community resource - a place for many, but not dependent on one individual or one source of money. And that's just what Dr. Mark Holt, a 1976 Southwestern Medical School graduate, and Dr. Darla Kincaid, class of '82, had in mind from the start.

The pediatricians, who started practicing together in 1985 and now practice privately at MD Pediatrics in Lewisville, were instrumental in getting PediPlace off the ground 10 years ago. It is the culmination of a shared dream to serve the many needy children they saw in their office. Denton County had no public hospital, and "there weren't really any resources for children who don't have any insurance," Dr. Kincaid said.

Dr. Holt remembers how passionate his colleague became about finding a solution to the growing problem. "One of the things that happened is that Dr. Kincaid basically said, 'Look, we need to have a way to assist them to manage in a medically appropriate and systematic way,'" he said. "This need is not just for kids who are on Medicaid or whose parents are in the lower socioeconomic group. There are lots of kids who fall through the cracks."

It was a scenario both doctors were familiar with when they were residents at Children's Medical Center Dallas. Parkland Hospital's Children and Youth Clinics - school-based, onsite medical homes for kids without a consistent private pediatrician - were "kind of the model we used for PediPlace," Dr. Kincaid said.

In 1990 Dr. Holt was a member of a task force conducting a needs assessment for southern Denton County. Out of that task force grew PediPlace's start-up board, made up of local community leaders, medical professionals and politicians.

"First, we wanted to be a system of care that centered on a medical home for kids that was basically something they could turn to both for well and sick care," Dr. Holt said. "Second, PediPlace is a community resource. It's basically not centered on an individual."

From the start, the doctors envisioned PediPlace not as a free clinic but as a business, where patients make appointments and pay for their care on a sliding scale, according to their financial situation. Funding comes from private and public donations from individuals and corporations, Denton County and surrounding communities.
The board also initiated a working relationship with the Denton County Health Department, so the two entities wouldn't unnecessarily overlap in providing services.

After two years of planning and fund-raising, PediPlace opened in November 1994. All along, community volunteerism helped get PediPlace up and running. "Firemen built the cabinetry," Dr. Kincaid recalled.

The doctors were also both deeply involved in making PediPlace work.

"In the beginning, we went every day," Dr. Kincaid said. Now that the clinic has several volunteers and 20 employees - including two pediatricians and four nurse practitioners - Drs. Holt and Kincaid only stop by a few days a month. But both continue to be involved at the board level.

Local pediatricians also donate both money and time to PediPlace, and the clinic recently added the services of an orthopaedist. Several nurse-practitioner students also have done internships at the clinic.

By any measure, PediPlace has been very successful in meeting the needs of its patients, offering check-ups, immunizations, hearing and vision screenings and mentoring for parents so they can better care for their children at home. It doubled its size last year, from 3,000 to 6,000 square feet. And this year alone, the clinic has had roughly 20,000 office visits, Dr. Holt said.

"We get everything from babies who are former premature infants to babies who are foster kids who need a medical home," he said. "The majority of our kids are either on Medicaid or on the CHIP program (the state-sponsored Children's Health Insurance Program)."

The goal now is to expand PediPlace's relationship with specialists and mental-health services and to "look at information systems and see how systems of care could be tied together on health-care information networks. Then you can share information," Dr. Holt said.

Best of all, he said, "We know that it's the kind of thing that has some staying power. It's been a nice kind of growth process."

"It's been fun," Dr. Kincaid agreed, "but I've gained more than I've contributed."