A community-based, nonprofit outpatient clinic in Washington, D.C., has been successful in using the medical model to provide high-quality services to low-income patients. In 13 years it has grown from five staff members and 17 patients to a part-time staff of 74 and a patient population of 1500. Hours of direct service have increased from 1000 to more than 40,000 per year. The clinic has matched the services provided in the city's public mental health clinics at a fraction of the cost. It receives no direct federal funding and only minimal assistance from state and local governments. It exemplifies the contribution the private sector can make in creatively serving the economically disadvantaged. Fiscal reality and patient demand emphasize the need for a strong and ongoing partnership between the private and public sectors if that population is to be served.