Dr. Wertheimer with her husband, Michael who is a surgeon, and their children Ben and Rachel

A career in medicine seemed like a natural fit for this young idealist. "I saw medicine as a universal good—something that was needed independent of cultural boundaries," explains Dr. Wertheimer. She thought she could use her medical skills in any context, in any place. "I had a very romantic, unrealistic notion of medicine," she now admits.

If her idealism has matured, Dr. Wertheimer's commitment to working with the needy has only deepened over time. She has weathered the frustrations and difficulties that often sour the charitable impulses of less committed people. For several years this eminently practical physician and administrator has organized and staffed innovative projects to help the poor.

A key to the success of these programs has been to involve the community in shaping the services offered. When the Medical Center of Central Massachusetts and Dr. Wertheimer were approached four years ago to provide onsite health care at Plumley Village, a local housing project, the first thing they did was hire an outreach worker, someone who had lived there for 20 years, to go door-to-door asking the people what they wanted in a clinic. "You have to do what the community needs and not what you define to be the problem," says Dr. Wertheimer.

As a family physician, Dr. Wertheimer had looked forward to creating long-term relationships with her patients so they could prevent or at least control chronic diseases like diabetes. What she learned was that the residents didn't necessarily want or have the time for that kind of relationship. "They'll come to us for immunizations, prenatal care and acute care services," says Dr. Wertheimer. "But with so much to deal with—getting food on the table and trying to find a job—preventive medicine is just not the priority it is for people whose lives are more stable. Relationships take much longer to build. It's a constant process—building trust and showing people that you are going to stay."

Dr. Wertheirner says that Community Builders, the organization that owns and operates Plumley Village, has brought a number of different social services under its roof. "The exciting thing about Plurnley Village is that all these services are working together," she says. "If we handle the medical piece, and others are working on the social and job issues, I think we can make an impact."

You'll find that same sense of collaboration in the School/Physician Program she developed. For years, Dr. Wertheimer brought family medicine residents into two inner-city schools. In addition to educating students about health, the physicians consulted with school officials about children with medical problems that interfered with their education. "As a team, the family physician, school nurse, psychologist, principal and teacher would meet to figure out how we were going to approach the problem," Dr. Wertheimer says.

Wertheimer felt the program was meeting a real need so she found grant money to offer the program to all the schools in the city. In its first phase, the redesigned program has paired practicing physicians with 20 of the city's 40 public schools. The physicians, usually assigned to a school near their practice, make bimonthly visits and are available for additional consultation as well. "Before this program, there was such a problem with communication," says Dr. Wertheimer. "The doctor wouldn't know what was happening in the schools and vice versa, and the end result was that the child didn't get the needed services. With less and less on-site medical support in the schools, this program has helped them resolve some of the students' medical needs so they can spend more time on the teaching issues."

It is really only in the last seven or eight years that Dr. Wertheimer has been able to devote herself full-time to her professional activities. The Wertheimers' daughter, Rachel, was born in 1978, just after Randy finished her internship at the University of Massachusetts School of Medicine in Worcester. She lengthened her residency to make more time for Rachel while her husband, Michael, a general surgeon just starting his practice, took responsibility for looking after the child while Randy was at work. "I don't think I could have felt comfortable working the schedule I did if he had not been such a strong nurturer," she says. It proved to be an unexpected growth experience for her husband, she adds, and his continuing commitment to the children has allowed her to pursue her career interests. She completed her residency in 1981, the year their son, Ben, was born, and worked part-time for several years so she could be close to her two young children.

Dr. Wertheimer recently received a Robert Wood Johnson Foundation grant through the Worcester District Medical Society to explore the barriers that prevent private physicians from taking care of underserved people. As part of the project, researchers will find out which local doctors are willing to see more people for free and then set up a database to link these physicians to underserved patients.

Does Dr. Wertheimer think she has achieved the goals she set for herself as a young idealist? "I feel like my work is richer than I ever imagined," she says. "I love working in the community and developing programs collaboratively to deal with some of the larger issues. When I was young, I envisioned one-on-one patient care with the poor, but I didn't envision having as large an impact on the community."