HUNTINGTON PARK, Calif. – The so-called bodega clinicas that line the streets of Los Angeles’ immigrant neighborhoods blend into a dense forest of commerce. Wedged between money order kiosks and pawn shops, these storefront doctors’ offices treat ailments for cash: a doctor’s visit is $20 to $40, a podiatry exam is $120 and at one bustling clinica, a colonoscopy is advertised on an erasable white board for $700.
County health officials describe the clinicas as a parallel health care system, servicing a vast number of uninsured Latino residents, yet the officials say they have little understanding of who owns and operates them, how they are regulated and the quality of the medical care they provide. Staffed with Spanish speaking medical providers, few of these low-rent clinics accept private insurance or participate in Medicaid managed care plans.
“Someone has to figure out if there’s a basic level of competence,” said Dr. Patrick Dowling, professor and chair of the department of family medicine at the David Geffen School of Medicine at the University of California, Los Angeles.
Not that researchers haven’t tried. Dr. Dowling, for one, has canvassed the local clinicas for years as part of his research for the state to document physician shortages. What he and others have found, however, is that clinca owners were reluctant to answer their questions.
What is certain, though, is that despite their name, many of these clinicas are actually private doctor’s offices, not licensed clinics which are required to report regularly to federal and state oversight bodies. It is a distinction that deeply concerns Kimberly Wyard, chief executive of Northeast Valley Health Corporation, a non-profit group which runs 13 accredited health clinics for low-income Southern Californians. “They are off the radar screen,” said Wyard of the clinicas, “and it’s unclear what they’re doing.”
But driven by fast-approaching deadlines set by the Affordable Care Act, health officials in Los Angeles are vexed over whether to embrace bodega clinicas and bring them – selectively and gingerly – into the network of tightly regulated public and non-profit health centers that are driven more by mission than by profit to serve the uninsured.