“I got a call from Dr. Slyman saying that I had been recommended for the position by a woman in our church,” Sandy recalls. “I didn’t even apply for the job.”
It was a part-time job to start, which as the mother of two young boys suited Sandy just fine. She soon knew she had found her true calling.

“When I walked into what was our first clinic under construction, I felt like God was saying this is why I put you on earth,” she says.

Like all free and charitable clinics, DMM had modest beginnings, opening in February 1992 in a small building that it rapidly outgrew. The clinic held hours one night a week to start, then two nights, then two nights and one morning. Sandy remained the only paid staff member until the late 1990s when the clinic added a part-time administrator and part-time pharmacy tech.

DMM hired its first paid provider in 2000. The clinic had also completed a capital campaign to fund a new building, which was two and a half times the size of the original clinic and opened in April of the same year. At the same time the clinic changed from a free clinic to a free and charitable clinic.

By 2005, DMM had opened its second location in Thomasville in the outpatient department of Thomasville Medical Center. Patients would come to the hospital cafeteria on Wednesdays to pick up medications DMM had couriered from Lexington. “You want fries with that?” Sandy jokes.

More change came a few years later when the Great Recession hammered the local economy. As the only safety net provider in a physician-underserved county, DMM was overwhelmed with new patients – laid-off workers who had lost their insurance and Medicaid recipients who couldn’t find a doctor.

“We were seeing patients that we knew had Medicaid and not billing them, but we couldn’t do anything about that,” Sandy recalls. “It was still more cost-effective and better for the patient and the community if we saw them anyway.”

The clinic nearly exhausted its budgeted reserves, but DMM’s board was committed to spending every dime it had to take care of people as long as it could.

“I told the board we have two choices: either spend until there was nothing left to spend or we can cut services, and cutting services was not an option.”

The experience of the recession and passage of the Affordable Care Act led DMM to another strategic crossroads in 2012 – establishing an FQHC as a separate entity alongside the clinic. Although the decision was made with the expectation that North Carolina would approve Medicaid expansion at the time, it enabled DMM, through its partnership with Kintegra Health, to serve the needs of Medicaid and Medicare patients and others who qualified for ACA coverage. And it provided a revenue stream to support care for the uninsured.

After another decade of growth, DMM now operates two standalone clinics in Lexington and Thomasville and a standalone dental clinic and serves about 4,000 patients a year with 13,800 patient encounters and the equivalent of 97,000 monthly prescriptions filled. A new mobile medical unit scheduled for delivery this summer will provide service to communities in the southern half of the county, where the lack of public transportation makes getting to DMM’s brick-and-mortar clinics a challenge for many patients.

After more than three decades as DMM’s founding and only director, Sandy knows that the challenges of running a free and charitable clinic come in all varieties – including Christmas Eve 2022 when frigid temperatures caused three water pipes to burst, flooding 80% of the Lexington clinic. The clinic missed only two days of seeing patients, and after providing services from several locations around town for six months, celebrated the reopening of the clinic in mid-July.

“My family that thought they were coming to Christmas Eve dinner at my house came to the clinic and pushed water out of the building for four hours,” Sandy recalls.

In addition to her work with the clinic, Sandy also takes pride in her status as a charter member of the NCAFCC. The association was actually birthed at DMM’s Lexington clinic in 1993 when the North Carolina Indigent Care Association was created, later to be renamed twice as the North Carolina Association of Free Clinics and ultimately its current name.

Sandy praises the association’s work to secure state funding during the pandemic as “lifesaving” for DMM, and points to ongoing efforts to provide a funding stream for member clinics as well as other forms of support as evidence of how far the organization has come.

“The elevation of what the association is and does is to the point now that there is just a lot of value in being a member,” says Sandy.

Now, with Medicaid expansion close to becoming a reality – and with it the prospect of many of its uninsured patients becoming Medicaid-eligible, DMM has undertaken another strategic planning process to determine how to meet the health-care needs of all regardless of their status.

For Sandy, it seems like the right time to pass the torch.

“My prayer had always been God, tell me when it’s time to go, because I didn’t want to outlive my usefulness,” Sandy says. “I feel like this year was when I got my answer. My plan is to get the Medicaid expansion project started and then the board will start looking for a new director at the beginning of 2024 and as soon as they hire that person I will transition out.”

Sandy won’t exactly be sitting on her hands once she passes off responsibility for day-to-day operations. She expects to stay involved with the clinics through board training, staff retreats and grant-writing. And she also plans to run for county commissioner next year so she can continue to serve her community.

“I feel like we need more focus on human services than we have now,” she says. “If I’m going to do it, I need to do it now while I still have name recognition in Davidson County. I do think I can make a positive impact now.”