COMPARED TO the big city health clinic a few blocks away, it's easy to miss the clinic at St. Elizabeth's Community Center.
Patients in the North Philadelphia clinic, in a converted church rectory on 23rd Street near Berks, wait in what used to be the foyer and doctors give flu shots in another room at the end of a long table, which will serve later as a sorting station for a toy drive.
The small clinic, a handful of rooms in the community center, is run by Project H.O.M.E., an anti-poverty and homelessness advocacy group based in Philadelphia, with help from Thomas Jefferson University.
Drs. James Plumb and Lara Weinstein founded the clinic in the mid-'90s to provide primary care for area residents - some have insurance, some don't - whose needs are not being met by the existing system.
Until about five years ago, Sheila Burton, 50, of Olney, was a regular patient at the clinic - known to visitors as St. E's - getting treatment for asthma, high blood pressure and diabetes.
Then she got insurance and switched to a primary-care doctor. But when she recently awoke one morning to find her hands numb, she returned to St. E's.
She liked it better, she said, so she switched her insurance to the clinic.
If not for the help she first received at St. E's, Burton said, "I'd be a lot sicker than I am. . . . I think I'd have something amputated," she said, with a chop of her hand.
"Every week, new people come in," said Monica Medina McCurdy, the center's Coordinator of Health Education and Services. "Most of them have challenges getting medical care. Either they have no medical insurance, and even if insurance, there are other challenges."
Since McCurdy began working with the clinic a year ago, the number of visits has increased by about 50 percent to between 700 and 800, she said, attributing much of the increase to a larger number of services provided.
About a third are from people without any insurance, she said.
The clinic has been working to find ways to deal with the higher numbers, McCurdy said."We're evolving and trying to plan and acquire property to build a more comprehensive wellness center," McCurdy said. The new center would provide multiple services including primary care, dental care, physical therapy and behavioral health care, plus a fitness center and a pharmacy.
The plan is to be "person-centered," she said.
William Twiggs, 51, who worked as a contractor, came to St. E's after being attacked in Germantown as he walked home from work one evening in March 2007. Three teenagers approached him, asked for a match and then attacked him. The assault left him with a torn rotator cuff and a broken right hand.
He went to the emergency room at Jefferson University Hospital and left with a semi-hard cast on his hand, unable to work.
"By the time my hand healed up, it was deformed," he said. "I don't have fine motor skills."
When Twiggs found his way to St. E's a few weeks later, "I was between a rock and a proverbial hard place," he said.
Though he had had insurance in his jobs previously, he didn't have any in his contracting job. The clinic helped him get state-issued insurance, though by then it was too late to treat his hand, he said.
At the same time, he learned that he had prostate cancer. Dr. Lara and the center helped him get an operation, and therapy and surgery for his rotator cuff injury. The state insurance helped cover the costs of his cancer operation.