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In 1925 James B. Duke willed $4 million to establish Duke Hospital and its medical school. His goal: to improve health care in the Carolinas, then a relatively poor region lacking in hospitals and care providers.

Duke Medicine has devoted itself to that goal ever since, making sure that people across the region are able to get the medical care they need regardless of their ability to pay.

In fiscal year 2013, DUHS provided $381 million in charity care and other community benefit investments. This includes charity medical care provided to low-income patients at a cost of $78 million, health professionals' education of $54 million, and in-kind service contributions and direct support payments of $10 million ($9 million to Lincoln Community Health Center and EMS). DUHS also absorbed Medicaid program losses of $64 million, Medicare program losses of $153 million, and unrecoverable patient debt at a cost of $22 million.

Community Partnership Facts

Duke works with many community partners to improve health care in its hometown, Durham, North Carolina. Examples of local outreach programs include:

  • Primary care Wellness Centers within four Durham public schools, serving mostly low-income youngsters: George Watts Elementary, Glenn Elementary, EK Powe Elementary, and Southern High schools. Clinics operate during the school year and provide medical and mental health services. The elementary school clinics also provide bilingual mental health services. All four Wellness Centers offer medical coverage during weekends and school holidays.
  • Just for Us, providing primary care, case management, nutrition counseling, and occupational therapy services for frail, medically complex elderly patients and adults with disabilities in their apartments, based in 13 public or subsidized senior housing sites operated in conjunction with Lincoln Community Health Center.
  • Lyon Park Clinic, a neighborhood clinic providing primary care to low-income Durham patients in a community center in Durham's West End, operated in conjunction with Lincoln Community Health Center.
  • Walltown Neighborhood Clinic, providing primary care to low-income patients at 815 Broad Street in Durham’s Walltown neighborhood, operated in conjunction with Lincoln Community Health Center.
  • Local Access to Coordinated Healthcare (LATCH), providing bilingual in-home health education on chronic disease, patient support, and advocacy for uninsured Durham residents; since 2002, more than 18,000 uninsured residents have enrolled in LATCH.
  • Learning Together, providing health education in selected public schools, assistance to patients to apply for public benefits, and support to Duke’s partner agencies through Duke staff and trained health learners.
  • ALMA (Amigas Latinas Motivando el Alma), a joint research program with the University of North Carolina at Chapel Hill to train Latinas in mental health coping skills and teaching those skills to their peers in Durham and Chatham counties
  • BieneSTAR, a bilingual mental health service for Latino families and children enrolled in the school-based clinics at EK Powe, George Watts, and Glenn elementary schools
  • African American Health Improvement Partnership, African-American Health Improvement Partnership,  providing health coaching and peer support to approximately 400 African Americans with Type 2 diabetes in Durham, and supporting the creation of sustainable support groups and strengthened health ministries.
  • Holton Wellness Center, located in the Holton Career and Resource Center, a neighborhood clinic providing primary care to low-income patients in conjunction with Lincoln Community Health Center.

Beyond Durham, Duke is making strides to improve the health of communities throughout the Carolinas:

  • ALMA (Amigas Latinas Motivando el Alma), a joint research program with the University of North Carolina at Chapel Hill to train Latinas in mental health coping skills and teaching those skills to their peers in Durham, Wake, and Chatham counties.
  • Northern Piedmont Community Care Network serves fifty primary care practices in Durham, Granville, Franklin, Vance, Person, and Warren Counties  by providing their 60,000 Medicaid patients with  in-home chronic-disease management, hospital transitional care (hospital to home),  medication reconciliation, social work,  health education, and patient advocacy.

Regional Outreach 

Duke works with care providers to bring advanced technology, treatment, and educational programs into rural areas. A few examples:

Duke Heart Network

The Duke Heart Network is supported by a dedicated team of clinicians and administrators with over 100 cumulative years of experience in building and enhancing cardiovascular programs. Services supported by the network include mobile cath lab sites, outpatient clinics staffed by Duke physicians and hospital-based cardiovascular program affiliations. Our most comprehensive relationships have been collaboratively developed with seven affiliated hospitals throughout the eastern United States, including Florida, North Carolina, South Carolina, Virginia and Michigan. 

Duke Cancer Network

The Duke Cancer Network (DCN) has established clinical affiliations, program development and research relationships with hospitals and oncology practices throughout the Southeast and beyond.  Locations include Florida, North and South Carolina, Virginia and Michigan. In addition to five clinical affiliates, Duke Cancer Network has eight research and five program development affiliations.  DCN relationships are tailored to each community and currently serve 13 AFFILIATES in 3 categories of affiliation.  The DCN creates teams with a breadth of expertise to address the diverse needs of individual communities and organizations providing oncology services.

Within North Carolina, DCN has established and supports a number of  clinical community oncology programs.  Duke has worked collaboratively with multiple communities to grow oncology services from the ground up.  Several of our affiliate programs now have full-time Duke oncologists based in the community with additional support from providers traveling out from Duke to address community needs. In 2013 approximately 3000 new patients were seen by Duke medical oncologists in their home communities. Additionally Duke supports radiation oncology programs with Duke radiation oncologists and physicists on site delivering patient care in three community programs.

All affiliations include a research component with more than 500 subjects enrolled in clinical trials in the local communities over the past three years.  In 2013, DCN research accruals have accounted for 56% of Duke’s enrollment in ALLIANCE/CTSU cooperative group trials (NCI funded research groups).