Travel Clinics Offer Advice to Go : Specialty practices are convenient places to get immunizations and information.

Sue Cravatt is an intrepid overseas traveler, partial to adventures in jungles and other remote locales. But the Palos Verdes Estates dental hygienist is always careful to find out what diseases are prevalent at her destination and to obtain all recommended immunizations. She could rely on her family doctor to provide them, but chooses instead to go to a specialty clinic for international travelers--one of a growing number of such facilities in Southern California.

For Cravatt, the drawing card is convenience. During the past four years, she has been a patient of Dr. Christopher W. Traughber, director of the Travelers’ Immunization Clinic at the Immediate Medical Care Center of Palos Verdes, which is affiliated with Torrance Memorial Hospital Medical Center. “He’s up to date on travel information,” Cravatt said. “I call ahead of time and tell him the region I am going to. Once I arrive, there is no waiting, no ordering of medicine.”

Convenience is what makes travel clinics attractive to most clients, said Traughber, who also directs the hospital’s other travel medicine clinic in San Pedro. Many of the clinics say their patients are referred by their own family doctors, who might not want to bother stocking the immunizations, reasoning that few of their patients will need them. Updated information on diseases at specific destinations is kept current at the Travelers’ Immunization Clinics, Traughber said, and “every immunization is available here all the time. We get advisory updates on outbreaks of disease every two weeks from the CDC (Centers for Disease Control), plus special bulletins (when conditions warrant).”

While consumers can get the same information by dialing the CDC International Traveler’s Hotline in Atlanta (404-639-2572), some aren’t willing to take the time or trouble.

The Travelers’ Immunization Clinics of Palos Verdes and San Pedro are like many others of their genre in that they are affiliated with hospitals but housed within free-standing emergency medical centers. In addition to inoculations, some also offer frills such as destination weather information, clothing advice and embassy telephone numbers. And although the field is not technically considered a specialty, a handful of area doctors in private practice offer similar services and have developed reputations as travel medicine specialists.

Travelers who use these clinics and specialty doctors can be assured of up-to-date, comprehensive information on disease prevention, advocates say. Yet critics counter that specialty clinics are nothing more than a slick marketing tool whose credentials consumers would be wise to check out carefully.

One factor in the clinics’ favor is operating hours. Most are open longer than a traditional doctor’s office. Travelers’ Immunization Clinics in San Pedro and Palos Verdes, for example, operate from 8 a.m. to 9 p.m., seven days a week. Another travel medicine clinic, which is part of the Centinela Hospital Airport Medical Clinic near LAX, operates 24 hours, seven days a week, said Dr. Ray Sahelian, director of its travel medicine program. “We have every shot needed for travel, plus anti-malaria pills,” he says.

The Daniel Freeman LAX Medical Clinic also offers travel medicine services and is open 24 hours a day, said administrator Sheila Driscoll, but travelers who need immunizations are urged to visit the clinic on a walk-in basis, from 8 a.m. to 8 p.m. daily.

The Travel and Tropical Medicine Clinic at UCLA has much briefer hours, said Patty Generalao, a patient representative. It is open 1-5 p.m. Tuesdays, and 9 a.m.-noon on Fridays.

While many of the specialty clinics operate on a walk-in basis, the UCLA clinic requires that clients call ahead for an appointment. And travelers must plan ahead, since it can take three to six weeks to complete an inoculation program.

Costs charged by the specialty clinics generally are comparable or lower than those charged by private practice doctors, clinic operators say, and the travel medicine clinics do not always charge an office visit fee. At the Centinela Hospital Airport Medical Clinic, for example, fees for injections range from $20 to $40 per shot and there is no office fee, Sahelian said. Travelers who need a consultation and prescription for anti-malaria pills pay a $20 consultation fee, plus medicine costs. At the Daniel Freeman LAX Medical Clinic, fees for injections are in the same range, said Driscoll, but the consultation fee for prescriptions is $10.

Yet consumers would be wise to check out travel clinics thoroughly before buying their services, advised Dr. Bernard McNamara, a Hollywood infectious disease specialist and USC assistant clinical professor of medicine who also has expertise in travel medicine. “Travel medicine is becoming more and more of a specialty.”

Being certain of a clinic’s expertise or a physician’s knowledge is important, said McNamara, who cited cases of patients who had been given inappropriate advice about immunizations for travel from their own family doctors.

Among ways to check out the expertise of travel medicine doctors: Ask about hospital affiliation, special travel medicine courses, other training and credentials and whether the doctor is in contact with the Centers for Disease Control for immunization information.

“Check out the cost (of the travel medicine clinics),” said Dr. Melvin Scheer, a Santa Monica internist with a special interest in infectious disease and travel medicine. “I don’t see a need for a special clinic. Most family doctors are familiar with the need for immunizations for overseas travel, and can get the information with a phone call in case they are not. Free-standing clinics offer no special competence,” Scheer said.

While private clinics that specialize in travel are slowly growing in number, so, too, are the number of community physicians offering travel immunizations, said Dr. Shirley Fannin, director of disease control for the Los Angeles County Department of Health Services. In addition, many private-practice groups now have one or more members who specialize in travel medicine, she said.

If travelers do decide to seek the services of a travel medicine physician or a travel medicine clinic, checking with their own doctor first is still a good idea, Fannin said. “Your own doctor knows you,” she said, and will be aware of any special needs.

Medicine to Go

A sampling of travel medicine clinics:

* Centinela Hospital Airport Medical Clinic, (310) 215-6020.

* Travelers Immunization Clinic, (310) 541-7911 in Palos Verdes Peninsula; (310) 547-4274 in San Pedro.

* Daniel Freeman LAX Medical Clinic, (310) 322-5393.

* UCLA Travel and Tropical Medicine Clinic, (310) 206-7662.

For referrals to doctors who can administer yellow fever immunizations, call Los Angeles County Department of Health Services, (213) 974-7941.

Orange County Health Care Agency, Public Health, operates an immunization program. For information, call (714) 834-8330.