FLAT-FEE CLINIC OPENS AT LA CLINICA AMIGA, HAVING NO INSURANCE IS NO PROBLEM.

Byline: Brent Hopkins Staff Writer

VAN NUYS - With health care costs rising, a group of doctors is offering patients without insurance low-cost, flat-fee medical care.

The 2-week-old facility, La Clinica Amiga, Spanish for ``friendly clinic,'' charges $50 for an exam, blood work and generic pharmaceuticals without involving a third party. Located in a strip mall in a former medical office, the building sticks out on a block lined with restaurants and retail shops.

``People wait until they get so sick that they have to go to the E.R.,'' said Peter Bracken, who serves as the clinic's nurse, physician's assistant and chiropractor. ``Then it costs them much more than it would have if they'd gotten it checked out. Here, we can spot something and say, hey, you need to take care of this.''

Sally Hayes hobbled in with a sore hamstring, barely able to stand and short on time.

The Canyon Country resident, a flight attendant with Southwest Airlines, pulled the muscle while exercising and needed care in a hurry. Without haggling over insurance, she paid the $50 fee out of her pocket, got examined, massaged, bandaged and sent on her way feeling better.

``That's a little bit tender, isn't it?'' Bracken said, kneading her thigh as she yelped in pain. ``You're not going to do anything; I'm going to do it all. Just relax. Keep heat on it, no ice. Get a little magnesium, build your muscles up.''

Hayes, used to waiting in long lines for her care, marveled that she was able to get out in less than an hour.

``I knew I had to do something,'' she said. ``This way you don't have to go to the emergency room.''

She was the sole patient for the first few hours that morning, but the clinic's managers expect once it hits its stride that they'll be treating between 50 and 100 people each day. They plan to offer vaccinations, preventive care, regular checkups and disease screening. With that volume, they expect to make a modest profit without having to deal with the hassle and overhead of insurance contracts.

The clinic's opening runs counter to recent trends in local health care.

In the past two years, the Valley has lost two major hospitals, in part because they had to treat uninsured patients, which strained their budgets. When Granada Hills Hospital and Northridge Hospital-Sherman Way closed, emergency rooms at other medical facilities became crowded.

So knowing that its patients probably won't have it, La Clinica Amiga's staff doesn't ask for insurance.

``A $50 flat rate for generic medication, lab work and a physician is a positive force to improve access to care, no question about it,'' said Jim Lott, executive vice president of the Hospital Association of Southern California. ``It has value, but it won't solve the problem. This isn't a panacea, but anywhere we can improve access for uninsured patients is a good thing.''

It's an ambitious goal, trying to serve one of the area's most densely populated, underinsured neighborhoods. That's why the clinic is staffed by one receptionist, one medical assistant, Bracken and a pair of doctors available for consultation.

Dr. Bert Rosenthal, a retired cardiologist and hospital executive who serves as the clinic's chief executive officer, acknowledges it's a daunting task. But he thinks the clinic can make a difference.

``The need here is the greatest, so we think this is where we can provide the best service,'' he said. ``If you're going to win the war, you'd better engage the enemy. You don't do that from five miles away, you do it from 100 yards out.''

Brent Hopkins, [phone]

brent.hopkins(at)dailynews.com

CAPTION(S):

2 photos

Photo:

(1 -- color) Sally Hayes of Santa Clarita is treated for a hamstring injury by Peter Bracken at La Clinica Amiga in Van Nuys.

(2 -- color) In the pharmacy at La Clinica Amiga in Van Nuys, Peter Bracken looks for medication for a patient.

John Lazar/Staff Photographer