When Drs. Robert Dweck, William Ellman, and Anna Timell joined forces in Amenia in 1990 to become Foothills Family Health Center, they were motivated by a desire to serve the people of eastern Dutchess County, a relatively isolated region of farms and country towns and villages, with high quality, personalized, patient-centered care. Little did they know when they set out what a circuitous route their journey would take.

As the high hopes for a new national commitment to affordable, quality health care for all were in tatters by the mid-90’s, the commitment of the founders to their dream and the realities of the medical marketplace led them to sell the practice to Sharon Hospital, located just 3 miles from Amenia in Sharon, Connecticut. Under the ownership of the hospital, the name was changed to Dutchess Medical Practice (DMP), and new sites were added in Pine Plains and Dover. But as health care costs, and the medical economy itself, continued to spiral out of control, Sharon Hospital began negotiating its purchase by Essent Health Care, a for-profit system based in Tennessee. Faced with the prospect that the DMP sites might be forced to close in the transfer of ownership, and after a chance meeting with Hudson River HealthCare’s VP for Community Initiatives Kathy Brieger, the senior clinical and administrative staff entered into discussions with HRHCare to explore the possibility of a merger. It was immediately clear, despite the fact that one was a private practice, and the other a network of community health centers, that the two organizations shared many of the same commitments, goals, and approaches to the provision of health care to their respective communities. Thus, on July 1, 2001, only 19 months after their first meeting, Dutchess Medical Practice became part of the Hudson River Community Health family.

The three sites employ 36 clinical and administrative staff, and serve approximately 13,000 patients in the northeast corner of Dutchess County. The service area includes the towns of Wingdale, Dover Plains, Washington, Amenia/Wassaic, Stanford, Pine Plains, and Millerton/Northeast. Patients also come from the western Connecticut towns of Kent, Sharon, Salisbury, and Lakeville. The 5 MD’s have admitting privileges at Sharon Hospital.

In addition to the farm families and rural residents who comprise the majority of the patient population, the practice has begun to draw from the growing numbers of ex-urbanites who commute to New York City for work. They also serve two “special populations:” migrant and seasonal farmworkers, and a significant number of patients who are developmentally disabled and/or mentally retarded. The payor mix includes 22% self-pay, another 22% Medicare, and 8% Medicaid.

What is it about “the practice” that has enabled it to retain the loyalty and affection of its large and varied patient population through all the changes of name, ownership, and corporate status over the last several years? Unquestionably it’s the people, people like Robert Dweck and Judy Marks, who were both there from the beginning, and who, in their different ways, exemplify the qualities that have won such a faithful following.

Dr. Dweck was in private practice in Millerton before co-founding the Foothills Family Health Center. In addition to the practice of family medicine, he has pursued an interest in Lyme disease, acupuncture, and herbal medicine. Dr. Dweck has an untiring commitment to the health and well-being of his patients, and he has been the driving force behind the survival of the eastern Dutchess sites.

Judy Marks, or “Queen Judy” as she is lovingly known, came over to Foothills from Millerton with Dr. Dweck. Like him, her devotion to the practice and to the patients has been single-minded and unwavering. Judy’s job might be described as “Jill of all office trades, and master of most.” She handles referrals, coordinates payroll, enters DEMS data, orders office supplies, makes the coffee, and is otherwise indispensable. For both patients and staff, it is a given that, when the chips are down, Judy comes through.

For our patients, many of whom are just getting by in this remote and marginal corner of rural New York, coming through when the chips are down is no small thing. Over the years, they have seen that our commitment to quality health care for all who come to us will not be compromised, and that our commitment to the communities and the people we serve will not be abandoned. We’ve come a long way, and we are here to stay.