Easing the Pain : Medicine: A private clinic, designed to serve needy youngsters and take pressure off the Childrens Hospital emergency room, quickly becomes a busy place.

Christina Becerra was agitated. A 7-year-old girl was in pain somewhere in the city and her parents had no transportation to bring her to Childrens Hospital Community Health Center, where Becerra works as head receptionist.

“She’s getting worse. She hasn’t eaten in two days,” Becerra told clinic doctors and nurses one night this week. “They have no car . . . their friends have no cars.”

Was there a 24-hour drugstore somewhere in the family’s neighborhood? No, the answer came back, not one that would accept Medi-Cal as payment. Could it wait until morning, when more buses would be running? No, she was doubled over with abdominal cramps.

Within minutes of Becerra’s pleas, hospital social worker Joshua Bienfeld sent a taxi to pick up the distraught girl and her mother. Two hours later, they were dispatched home after doctors had given the girl an injection to relieve the cramping, diagnosed a virus, discovered head lice, issued prescriptions and furnished addresses of pharmacies that woiuld accept Medi-Cal.

It was another crisis averted by the center, the first hospital-based private health clinic in Los Angeles aimed at delivering basic medical services to needy children, who previously might have lingered for hours in the facility’s emergency room.

Open for only a month, the clinic is already swamped with patients. Providing service until midnight seven days a week to accommodate working parents, the clinic sees about 100 patients daily for ailments that range from colds to constipation, sore throats to strep throats.

The clinic, located across Vermont Avenue from Childrens Hospital, is the brainchild of the hospital’s emergency medicine director, Dr. Nancy Shonfeld. Shonfeld had become increasingly concerned about the flood of children who came into the emergency room in recent years with routine health problems.

They were waiting too long to be seen, alongside children who were much sicker, Shonfeld noticed. They were not getting the full physical exams that Shonfeld and others believe should accompany their visits. And their treatment was unnecessarily expensive--made costly by the emergency wing’s expert and highly paid staff and its sophisticated equipment.

The hospital’s own studies fueled her worry. They showed that up to 40% of the children seen in the hospital’s emergency room were there for mundane medical problems. They were often shunted to the emergency room because their parents lacked health insurance or worked day hours when most private clinics were open.

“We had kids with colds who were competing to be seen with kids with meningitis,” she said. “We were treating their acute needs--telling their parents, ‘Your child has a cold. Your child has an ear infection.’ But we knew we should be doing more . . . we knew that we were their only source of health care.”

Three years ago, a wing of the Childrens Hospital emergency division was set aside for the lower-level care. But Shonfeld wanted more space and a free-standing facility so that the children would not have to detour through the emergency room.

A vacant medical office across the street from the hospital owned by a retired and sympathetic doctor provided the opportunity. Financing came in the form of $400,000 in grants from the hospital and from Shonfeld’s fellow emergency doctors.

The clinic opened its doors on July 23, staffed by resident physicians, nurses and social workers who rotate in from the main hospital. The facility accepts Medi-Cal, which Shonfeld said accounts for about 70% of the patient load. Other patients are charged what they can afford, usually about $25 a visit.

Complete physicals are offered whenever time allows, as are immunizations which are provided free under a Los Angeles County health program. Although the clinic aims to treat the surrounding community, patients have come from as far away as Valencia.

The waits are still long--up to three hours at times. Last Thursday night, as the children sat in a crowded waiting room and grew crankier, some parents lost their patience.

In rapid Spanish, Elizabeth Avena shouted at one of the medical assistants: “If the doctor’s not coming, I’m leaving now!”

Avena, who lives in Huntington Park, had been referred to the clinic by the hospital’s emergency room. Her 11-month-old son, Armando, had a fever that had lasted three days. There was another late-night clinic closer to her residence, but she did not like her previous treatment there.

Within 15 minutes, Avena’s son’s virus had been diagnosed by attending physician Eyal Ben-Isaac and she left, smiling, with her son cradled on her shoulder.

“It’s OK, it’s OK,” she said.

Ben-Isaac fears that as the clinic’s popularity increases, so will the crowding. He is less convinced than Shonfeld that the emergency room will experience any decline in patients.

“Once people hear about this place, we may actually see more people overall,” he said.

Indeed, there has been no noticeable drop in emergency room business yet, though that is being blamed in part on the state budget impasse, which has prompted more hospitals to turn away Medi-Cal patients.

Projections that the clinic would treat 22,000 patients in its first year were quickly amended last week. If the average daily load of about 100 holds, there will be more than 35,000 patients this year. The Venice Family Clinic, by comparison, treats more than 45,000 annually.

Shonfeld shares concerns that the clinic might be overwhelmed. But she hopes that it will become a model for similar satellite centers around the city. In addition to the hospital’s financial backing, she is attempting to create a clinic foundation that would help defray the clinic’s costs and hopes local business owners will support it.