Ian Dryden

In the early 1970s, a handful of San Diego “free” clinics struggled along on private donations and limited county and city funding. Revenue sharing, introduced by the Nixon Administration, opened up a steady source of funding for these clinics; since then the free clinics have become fee clinics, with the exception of the Beach Area Community Clinic, which requests donations. The remainder of the 18 San Diego County community clinics now charge patients on a sliding scale based on the patient’s ability to pay; what might cost hundreds of dollars at a private clinic, can cost only a few dollars at a community clinic if one’s income is low enough.

According to Steve Shubert, director of the Council of Community Clinics, the combined programs now treat 185,000 patients each year. “The community clinics are important for people who just can’t keep up with the rising cost of medicine,” he maintains. “Since many doctors in San Diego resist seeing people on Medicaid or Medicare, the community clinics are especially important.”

Still dependent on idealistic doctors, usually young, who volunteer their time and forgo some of the income demanded by most physicians, the community clinics increasingly use Physicians Assistants, Nurse Practitioners, and other health-care extenders. “If a program can’t treat a problem, the patient is referred to a private local specialist,” adds Shubert.

The clinics are now including some rather diverse methods of treatment, from the time-tested and familiar methods to acupuncture and biofeedback training. “Several of our clinics also can assist patients in locating a needed social agency, or figuring out how to get food stamps,” says Shubert. With the exception of Womancare and The Senior Citizens Clinic, the community clinics generally treat anyone who walks in the door. Some clinics, after a first visit, try to discourage patients residing outside the immediate neighborhood from returning, however.

What follows is a run-down of the community clinics, including the basic services, particular philosophies, addresses and phone numbers. For clinic hours (which change frequently), referrals, and any other questions, call the Council of Community Clinics at 292-9536.

SAN DIEGO AREA CLINICS

• Beach Area Community Clinic 3705 Mission Boulevard, 488-0644.
• Probably the best-known community clinic, because of its early emphasis on treating youthful transients, the Beach Area Community Clinic now includes a general medical clinic, an outreach program of alcohol and drug counseling, and an extension clinic in Ocean Beach. A women’s clinic includes prenatal care, OB-Gyn, feminist counseling, and general medical services. The Beach Area Clinic is widely respected, especially for its expertise in treating venereal disease. Unlike other community clinics, it remains a “free” clinic,requesting, but not requiring, a donation (average donation is $5).

• Chicano Community Clinic, 1809 National Avenue, 234-8171.
• This bilingual clinic offers general medical services, maternal health care, well-baby services (up to two and one-half years), pediatrics, OB-Gyn, speech and hearing, cardiology, dental services for children, mental health services, family planning, and podiatry. In addition, the American Cancer Society conducts free pap, pelvic, and breast exams.

• Linda Vista Health Care Center, 6963 Linda Vista Road, 279-0925.
• A family-centered clinic with an emphasis on low-cost preventive medicine, the Linda Vista Health Care Center offers an especially wide range of services, including general medical, free blood-pressure screenings (to check for hypertension), pediatrics, women’s clinic, OB-Gyn, cancer screening, family planning, pregnancy testing, prenatal care, home care, and health education. Psycho-social services are also available, including individual, group, couple, and family counseling. The services even extend to weight-reduction groups, and training in assertiveness, biofeedback, and relaxation. This clinic tries to limit its attention to residents and workers of the Linda Vista area, and to students at USD and Mesa College. The clinic will see patients from outside that area on a one-time basis only.

• Mid-City Community Clinic, 4290 Polk, 563-0250.
• A small clinic, Mid-City’s goal is to “de-emphasize mysticism in medicine and make it available to all people regardless of income.” Mid-City stresses “holistic” medicine (the treatment of the whole human being, emotionally, physically, and environmentally), and provides broad services: general medical, a women’s clinic, family planning, prenatal care, with specialty services in podiatry, nutrition counseling, family and individual counseling, child health and disability prevention, “rap groups,” pediatrics, and seniors’ screening.

• Senior Citizens Community Clinic, 3545 Fourth Avenue, 299-6340.
• (Southeast location: 286 Euclid Avenue, Suite 307, 262-2111.)
• Providing health care to 600 seniors each month, the Senior Citizens Clinic fills an important gap in San Diego’s health care. According to Steve Shubert, “In San Diego, seniors have difficulty finding doctors who will accept seniors on Medicare. This is because of the belief among many physicians that they aren’t sufficiently reimbursed, and also because of patient loads.” The Senior Citizens Clinic, limiting its services to patients 55 years old or over, is staffed by visiting internists, dermatologists, psychiatric social workers, ophthalmologists, urologists, orthopedists, and gynecologists. Fees are reimbursed by Medicaid or are charged on a sliding scale.

• Southeast Community Crisis Center, 2754 Imperial Avenue, 239-0325.
• A neighborhood walk-in facility, the Community Crisis Center provides emergency services including crisis intervention, legal assistance, and counseling, as well as general medical services, including pediatrics, women’s clinic, podiatry, and prenatal care.

• Womancare, 424 Pennsylvania Avenue, 298-9325.
• The only community clinic which provides abortions in its own facility. Woman-care also offers a child-birth program, pregnancy screening, IUD’s, and a “well-woman” clinic. The emphasis is on self-help and all services are group-oriented.

NORTH COUNTY CLINICS

• Vista Community Clinic, 114 Hillside Terrace, Vista, 726-1321.
• A large clinic noted for its individual attention, the Vista Clinic offers general medical services, a women’s clinic, and a seniors’ clinic. Premarital blood testing and pregnancy testing are available without appointments. Other specialties include dietary counseling, lab services, a child health and disability program, blood-pressure clinic, spoils physicals, counseling services, home visits by a registered nurse, and abortion referral.

• Escondido Community Clinic, 401 North Spruce, 747-6610.
• Services including general medical and a family planning clinic are offered through agreements with local health-care providers.

• Oceanside Community Clinic, 263 Airport Road, 757-4566.
• A bilingual clinic, this program offers well-child screening, general medicine, pregnancy testing, pap smears, and a hypertensive clinic.

• North County Health Project (clinics in Pauma Valley, Ramona, Santa Ysabel, Julian, and San Dieguito), 309 Firebird, San Marcos, 744-1455.
• Serving people in rural areas of the county devoid of, or limited in, health-care services, this bilingual project relies on Nurse Practitioners who work under a set of rules established by local physicians. Special referrals and hospitalization are arranged with the nearest local health-care providers. Community Health Workers help identify individuals who can be referred to the Welfare Department for aid. Health educators and community health workers also offer courses in first-aid, home health care, diet and weight control, nutrition, prenatal care, infant and child development, prevent-adontics, and teen problems. In-clinic services include general medicine, women’s clinic, family planning, OB-Gyn, prenatal care, seniors’ clinics, pediatrics, mental health counseling, a dietitian, a dental hygienist, sports physicals and health education. This is the only community clinic working with Tel/Med, a Medical Society program using taped health information dispensed over the phone.

• East County Community Clinic, 357 South Magnolia Avenue, El Cajon, 440-2751.
• This program offers blood-pressure testing and general medicine on a walk-in basis, with women’s clinic and general medicine by appointment. Patient counseling and social services are available, as well as specialty clinics in dermatology, ophthalmology,child health, and disability prevention.

• Mountain Health Project, Route 1, Box 618, Campo, 280-3040, x31.
• The newest community clinic, Mountain Health serves rural East County, taking in a high percentage of Indians and seniors. Para-professionals provide services in remote areas and remain in contact with a San Diego physician (who also works in the central Mountain Health clinic) via closed-circuit TV. The central clinic prefers visits by appointment, and offers general medical services, family planning, OB-Gyn, social services, and transportation services. Professionals are also available, primarily for seniors and the disabled, as homemakers, handymen, and home nurses.

SOUTH BAY CLINICS

• Imperial Beach Community Clinic, 154 Palm Avenue, 429-3733.
• This clinic’s medical capacity ranges from treating common colds to minor surgery, and extends to social and educational services such as a women’s education group and a court/probation diversion program, as well as ongoing referral, follow-up, and education for clinic clients. The clinic also operates an on-site pharmacy where patients can fill their prescriptions. In addition to standard medical services, the program provides a prenatal clinic, a child health program, sick-baby clinic. La Maze childbirth classes, podiatry, nutrition counseling, and screening for hypertension, cancer, and diabetes.

• Otay Community Clinic, 1249 Third Avenue, Chula Vista, 425-1780.
• Appointments are requested for all services, including general medical and women’s clinic, prenatal and pediatric ser-ices. Preschool physicals and immunizations are also available by appointment, as well as individual, marital, and family counseling.

• Samahan Health Clinic, 2340 E. 8th Street, Suite D, National City, 474-6549.
• This clinic places particular emphasis on minorities. Fifty percent of its patients are Filipinos or Asian-Americans. But low-income and disadvantaged families are welcomed regardless of race, age, or sex. Services available include general medical, OB-Gyn, pediatric, and lab tests. In addition, social services, diet counseling, and health education workshops are provided. A specialty clinic in acupuncture is also conducted.

• San Ysidro Community Health Care,
• 4004 W. Beyer Boulevard, San Ysidro, 428-4463.
• The largest, most comprehensive community clinic, San Ysidro Health Care offers the full range of bilingual clinical services, including internal medicine, a dental program, community nursing, and home health care, mental health services, social services, a pharmacy, speech and hearing diagnosis and therapy, and community health education. Specialty clinics include podiatry, optometry, and radiology.