Hudson Clinic’s Emergency : Caseload Up 30% Since Shooting at County-USC Urgent Care Unit

Kim Strange had to wait four hours to get a cough medicine prescription for her 2-year-old, but the woman was not complaining.

She expected to spend the entire day at the H. Claude Hudson Comprehensive Health Clinic waiting to be seen by a doctor. “I got here around 8 and I didn’t expect to leave until 5,” said Strange.

A normal wait at the urgent care unit of the South-Central clinic is about two hours. But since the Feb. 8 shooting that temporarily closed a similar unit at County-USC Medical Center, the number of patients arriving daily for care at Hudson has jumped 30% and the waits have been as long as seven hours, doctors said. Although County-USC has reopened its critical care unit, Hudson has been swamped because more patients have discovered it.

“The system is busting at the seams,” said Donald Pierre, a full-time physicians’ assistant at the unit. “But at least we’re seeing the patients before any catastrophic event happens. I just hope we don’t have a repeat of (the County-USC shooting) here.”

The recent increase of patients at the urgent care unit has exacerbated other problems, such as limited space and too few doctors. In addition to emergency care, doctors have found themselves providing basic family health care when other physicians in the clinic are too busy.

Several doctors at the urgent care unit worry that they may be the next victim of a hostile patient.

“We’re working in an unsafe environment, in a facility in which we’re getting no support” from the clinic’s administration, Pierre said.

Fred Gadson, administrator for the Hudson facility, said there is support for the urgent care unit and efforts are being made to work out some of the problems.

“If we here at administration had the authority and resources to do what needs to be done--if we had an open checkbook--we would’ve done something,” Gadson said. “But there are priorities that need to be set by my supervisors and the county Board of Supervisors.”

The Hudson center is one of the county’s six comprehensive health clinics, offering specialized medical services--such as family planning, pediatrics and dermatology--to low-income and poor residents. Forty other county health centers serve basic public needs.

Most of the facility’s patients pay nothing or a minimal fee for medical treatment. Many are covered by Medi-Cal insurance, but those who do not have insurance pay fees depending on what they can afford after a financial screening, Gadson said.

The urgent care unit was built in 1988 to handle about 125 patients a day, but now sees twice that many. And the county’s recent budget cuts slashed the clinic’s $1.8-million budget by about one-third, forcing a staff reduction from 39 to 26.

“It’s been a drain because our space has been designed for 2,500 patients per month. The big problem we have now is getting space,” Pierre said. The unit has treated as many as 5,000 patients since the shooting at County-USC.

For the past three years, doctors at the urgent care unit have repeatedly requested additional examination rooms, but have not received them, Pierre said.

Gadson, who has met with doctors from the urgent care unit, said he and other officials are in the process of reviewing the most recent request for the unit to use several nearby outpatient surgery rooms now occupied for only part of the day.

But freeing up that space would mean “we’d have to control the number of patients that we see and we can’t do that,” Gadson said. “We don’t turn anyone away.”

Without the additional rooms to examine patients, there is a constant backlog, doctors said. The result has been that patients such as Maria Gonzalez must wait four hours with her 28-day-old baby and 3-year-old daughter. The infant, also named Maria, had been coughing for several days, Gonzalez said. “I just hope we can see the doctor soon,” she said.

Doctors said patients such as Gonzalez often return to urgent care for a regular checkup because of the difficulty getting an appointment with a regular doctor at a clinic. It could be as long as three months before a patient can be seen, some doctors said. This results in about 60% of the patients seen at Hudson’s urgent care unit returning for follow-up care.

“The (county health) system is so bogged down there is no place else for these patients to go so we have to see them for whatever problems they have,” said Pierre.

The real sufferers are the patients who have to wait hours to be seen by a doctor who may only have five minutes to spend with them, said Dr. Andrew Griscom, a senior resident at County-USC who works at Hudson five or six times a month.

Joseph English, 43, sat patiently at the end of a long row of people for 40 minutes for a prescription for his high blood pressure. He wasn’t sure when he would be called.

“It gets a little frustrating, but I know these types of places. You have to be patient,” said English, who lives in the Downtown area. “The general pace of a place like this is to spend all day here.”

However, English said he didn’t mind waiting for care because he believed he received good medical attention at Hudson.

“Compared to the other county facilities, it’s a lot quicker and the doctors that I’ve seen have spent about 15 minutes with me explaining what I should know about high blood pressure,” English said.

But spending 15 minutes with a patient is not possible at Hudson lately, doctors said, with the backlog of patients and the limited number of examination rooms. Instead, the patients sometimes get hustled in and out depending on the extent of their ailments.

“We have to work a little faster,” said Jagne Ibrahim, a physicians’ assistant. “You’re talking about trying to see as many patients as possible so they’re not waiting 12 hours. And no matter what you do, some people are still frustrated and angry when they finally see you.”

“In spite of everything, we’ve managed,” Pierre said. “But we can’t be expected to continue to do the same thing with less money, less people and not enough space.”

Times staff writer Robert Lopez contributed to this story.