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For-Profit Urgent Care Carving Out A Niche In San Diego

For-Profit Clinic Offers Alternative For Health Care

If you can pay, you can be seen by a doctor at a new urgent care clinic in Santee. KPBS' Kenny Goldberg has this report.


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— There's a new player on the local health care scene. Doctors Express is a national chain of for-profit urgent care clinics. It's opened its first San Diego County location in Santee.

The clinic promises quick, convenient care without an appointment. Doctors Express is designed to bridge the gap between primary care doctors and hospital emergency rooms.

Most urgent care clinics are located near hospitals or medical office buildings. Doctors Express is in a Santee strip mall. It's just steps away from a fast-food shop that sells five-dollar foot-longs. But there's nothing bargain basement about Doctors Express.

Unlike most retail clinics, Doctors Express is staffed by physicians like Jennifer Doumas. Next to her exam room is a digital X-ray machine, and a well-equipped lab.

Dr. Doumas said the goal at Doctors Express is to ease some of the pressure off hospital emergency rooms.

"Their job is to really see the life-threatening things," Doumas said, "and not be burdened with the sore throats, the minor things, that we can handle here. The other place I think we really fill well is the primary care doctor, who's too booked to see somebody for an urgent problem."

That's why Lakeside resident Jeannie Crawford dropped by the clinic.

"Well, my regular doctor is always busy," Crawford remarked. "You have to kind of make an appointment in advance. And the secondary doctor I go to, he doesn't work on Mondays. Then that leaves me with the nurse practitioner, and I prefer to just see a regular doctor."

Crawford didn't have an appointment. But she was seen within 20 minutes at Doctors Express.

Former health care executive Paul Arvanitis owns this clinic. He says he chose this spot in Santee because of its population density, median income, and the lack of similar clinics in the area.

A visit to Doctors Express runs about $108. Lab work is extra. The clinic accepts all major insurance plans. And there's a discount for people who pay cash.

But Arvanitis said the uninsured who can't pay anything have to go somewhere else.

"It it's an urgent situation where the person's bleeding, we'll do what we can for them and send them on their way," Arvanitis pointed out. "But we're not really at a place where we can provide free care."

While Doctors Express can turn away patients who can't pay, hospital emergency departments are required by law to treat everyone.

That's one reason why patients come into the emergency room at Scripps Mercy Hospital.

A study by the Rand Corporation estimates 27 percent of ER patients could be treated at an urgent care clinic or a doctor's office.

Dr. Valerie Norton oversees Mercy's ER. She said it's possible that clinics like Doctors Express could siphon off patients, and cherry pick the ones who have insurance. But she says even if that happened, her ER would stay in business.

"We'd still have plenty of traffic," Norton said. "We'd still have plenty of uninsured patients who don't have anywhere else to go, and we'd still have plenty of patients with major emergencies.

Paul Arvanitis says Doctors Express isn't trying to steal business from anyone - they're not equipped to handle life-threatening emergencies. Arvanitis says they're trying to give people in East County an option when they can't get in to see their doctor.

And what about opening more locations in the county? Arvanitis said he's thinking about it.

"San Diego County is not under supplied in terms of health care," Arvanitis said. "If fact, it's quite rich. But there are gaps. There are opportunities. And those are the areas that are most attractive to me."

There are currently 28 Doctors Express urgent care clinics nationwide. The company says they hope to have 40 operating by the end of March. A new one will open in Oceanside later this month.


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