Doctor makes a city call
As Philadelphia's new top health official, Donald F. Schwarz brings an energetic style to an ailing bureaucracy.
When the neighbors he hired to reduce household injuries were too scared to visit a public housing project, Donald F. Schwarz went himself.
When those workers got sick, he took them homemade soup.
Nearly 20 years after Schwarz practiced at a health clinic at 39th and Chestnut Streets, parents still remembered the soft-spoken pediatrician calling their children "ticklebugs" and answering their calls.
His newest patient, however, is sure to be his biggest challenge: Philadelphia.
As Mayor Nutter's pick to run seven city departments with a $2.5 billion budget, Schwarz, 51, now oversees everything from the city health department to Fairmount Park. His domain includes services for abused children, the mentally ill and the homeless.
A former high-ranking physician at Children's Hospital of Philadelphia, Schwarz will need all his moxie to fix what ails the city.
Residents often wait months to see doctors at city health centers. Homeless people are overwhelming shelters. And the Department of Human Services, which failed to prevent the deaths of dozens of abused children from 2004 to 2006, remains a work in progress.
As deputy mayor of health and opportunity and health commissioner, Schwarz will have to change the ways of an entrenched bureaucracy; and he will have to answer for the failings of those under him.
In September, acting health commissioner Carmen I. Paris quit after the agency allowed an employee to work two jobs simultaneously in Philadelphia and Washington.
Schwarz chose to take his new job despite a pay cut. He made $425,265 a year for holding several posts at Children's Hospital, including deputy physician-in-chief. He now earns $160,000 as a deputy mayor.
Schwarz expects tough times ahead.
"I'm realistic that the odds are there will be some terrible thing that will happen, and I'll be out - because I'm responsible, or because I have not been able to move the system along fast enough," Schwarz said. "In the meantime, I'm working to get as much accomplished as I can."
He's already played a key role in Nutter's first major homeless initiative, announced in late May, enabling the city to create 700 new beds and eventually receive millions of dollars in state and federal funds.
Philadelphia Housing Authority director Carl Greene cited Schwarz's "brilliant ingenuity."
Jeanne Ann Grisso, who taught with Schwarz at the University of Pennsylvania and now works for the Robert Wood Johnson Foundation, has known the now-graying doctor for decades.
"He's not gaming to be a politician. He's not into power," Grisso said. "What drives him? I don't know . . . sainthood?"
Schwarz grew up in the 1960s and 1970s in Dover, N.J., a then-rural Morris County town with a large Hispanic population.
It was a good place to learn how to get along with people, Schwarz said.
His father was a land appraiser and Realtor, Schwarz said, who helped modernize land appraisal.
His brother still operates the family firm, Harry L. Schwarz & Co. Schwarz owns 14 percent of the stock.
His mother was a homemaker. Both his parents are now deceased.
Schwarz graduated from Brown University in 1977 and went to Johns Hopkins School of Medicine, where he also earned a master's degree in public health.
He did his residency at Yale-New Haven Hospital and moved on to the University of Pennsylvania School of Medicine, and the Wharton School.
He began working at Children's Hospital and teaching at Penn medical school in 1987.
While there, he became known for devising a way to track and prevent injuries.
"He was a true missionary," said Walter Tsou, public health director under former Mayor John Street.
In 1987 Schwarz was able to get all 11 emergency rooms and the city health department to track injuries, so he could develop a way to stop them, Tsou recalled.
Tsou called it a monumental feat to get all the hospitals to work together.
"Don is a natural at figuring out the politics to get something accomplished," said Tsou, former president of the American Public Health Association.
At Children's, Schwarz negotiated with insurers and learned to manage hundreds of doctors with all their egos and ambitions.
"He worked seven days a week," said Louis M. Bell, chief of the hospital's Division of General Pediatrics. "It's taking a lot of people to replace him."
Nutter's advisers identified Schwarz as the best person to restore the agency's preeminence, but thought he would never leave Children's Hospital.
"It never hurts to ask," Nutter recalled saying.
The two men talked for more than two hours.
"Don Schwarz is possibly one of the most understanding and empathetic people that you'll ever have a discussion with," Nutter said. "He's not just thinking 'Let's solve this problem.' He's trying to figure 'How did this happen in the first place?' He's trying to figure out how to change the system."
Schwarz was won over, too. He had gone to the meeting with Nutter feeling ambivalent.
"I had worried about corruption," he said he told Nutter. "I did not want to be put into a position where I would be tainted."
Nutter reassured him on his commitment to transparency and openness.
Schwarz left the room feeling that he'd just had the most significant conversation of his professional life.
Schwarz initially accepted the job as health commissioner, thinking he would report to a deputy mayor.
But Nutter was impressed and later offered him a deputy mayor post, overseeing seven departments: public health, behavioral health, human services, the Free Library, the Fairmount Park Commission, the office of supportive housing, and the department of recreation. Schwarz added the word opportunity to the title.
Both men were concerned about the city's children. Infant mortality here is nearly twice the national average.
They also agreed that services are seldom coordinated.
Schwarz has been seeing that problem since the late 1980s. A family that is borderline homeless and lacks food may also struggle with substance abuse, physical abuse and unemployment. That family has to deal with at least three city agencies.
"The system hasn't changed," Schwarz said. "The challenge is to say, 'Let's coordinate this.' "
At a recent meeting of PhillyStat, Nutter's program to measure city performance, the scope of Schwarz's new position was on full display.
Over three hours, he answered questions from Managing Director Camille Cates Barnett about poor air quality (just 48 percent of the days in the city are cleaner than national standards); tree canopies (the Fairmount Park Commission wants to plant more trees); and after-school programs (the after-school nonprofit Philadelphia Safe and Sound has closed and the city needs to find activities for thousands of children).
When Barnett asked Schwarz about wait times at city health centers, he explained there are too few staff members and too many exam rooms being used as waiting rooms or for storage.
Schwarz hopes to convert those rooms for patient use and hire more doctors.
Frances Walker-Ponnie, 69, has seen Schwarz in action, beginning when he was a young researcher. Walker-Ponnie is a longtime activist who founded the group Parents Against Drugs, and worked with Schwarz on his injury surveillance project.
She still calls him "my Don." She also calls Mayor Nutter "Michael."
For years Schwarz would ask Walker-Ponnie to speak to Penn medical students about life in West Philadelphia.
"One day he was late for class and he came in and just broke down because he'd just lost a patient," Walker-Ponnie recalled. "Those students really felt him."
Schwarz's patients gave similar recollections.
"I could call him any time," said Tyra Hadley Pomeyie, 35, who 18 years ago as a scared teenager brought her then 2-week-old son Norman to see Schwarz. "He always called me back. I felt like we were friends."