Dr. Fred Thomas and his patients on Los Angeles' Skid Row have to overcome a few obstacles that most physicians and patients in the suburbs never encounter.
For one thing, there is the problem of a waiting room. His patients--a mix of working people in low-paying jobs, junkies, the homeless and other street people--must wait for him on metal folding chairs set up on the sidewalk outside the Los Angeles Mission.
Then there is the examining room, set up inside a gutted house trailer. There was a slight tilt to it Tuesday, perhaps caused by a low tire or maybe, as someone suggested, the leveler that keeps the thing in balance was just a bit off.
Still, no one was complaining.
The clinic that Thomas and other health workers with the Watts Health Foundation operate on the corner of Wall and Winston streets got a big upgrade.
It came in the form of a shiny, new 40-foot coach, with state-of-the-art X-ray and radiology equipment, said to be the first of its kind in the state, that rolled up and parked in front of the trailer.
The rolling X-ray room is the latest brainchild of Dr. Clyde W. Oden Jr., the head of the Watts Health Foundation. It was financed by a $400,000 grant from PacifiCare Foundation.
Oden, who also heads United Health Plan, loves to show the medical industry that it is possible to practice medicine in the inner city and thrive. Years ago, the Watts Health Foundation, created in the aftermath of the 1965 riots, outgrew its boundaries. It now operates 30 programs, serving about 200,000 patients a year, in several counties. United Health Plan, the foundation's HMO, is the 10th largest in Southern California, with billings of about $200 million a year, Oden said.
Even the trailer was something of a trailblazer.
Medical officials generally regard the Skid Row area as having more serious medical problems per capita than anywhere in the city--patients with tuberculosis, AIDS, venereal disease and knife wounds regularly walk through the door of the clinic-in-a-trailer. And there is less money and fewer resources to deal with the problems than just about anywhere else in the city.
For that reason, not too many clinics and medical practices start up in downtown Los Angeles. As Thomas puts it, "We see folks who oftentimes are not well-appreciated by other institutions."
Still, there was clearly a need and, Oden figured, enough public and private money to finance at least a limited operation.
The idea of a clinic on wheels came about because the foundation could not find a building reasonable enough, or safe enough, or with enough parking, for a permanent clinic. But the trailer had limitations. "When a person needed an X-ray, we either had to send them to one of the local hospitals, or send them back to Watts, which was a long way," Oden said.
Four years ago, Oden said, the foundation began thinking about building a mobile X-ray room. It could be moved around, with the trailer, to medically underserved communities throughout Southern California. Then came the rioting in South Los Angeles last spring, which got the attention of PacifiCare Foundation, an arm of PacifiCare Health Systems, one of the nation's largest commercial health care organizations. PacifiCare went to Mayor Tom Bradley, who in turn introduced them to Oden. The result opened its doors Tuesday.
It will park outside the Los Angeles Mission one day a week. Other stops will be homeless shelters, parks, day labor sites and anywhere else people live, as Oden puts it, "on the margins of society."
The X-ray unit is expected to do 5,000 mammograms and 3,000 general X-rays a year.
"This will go wherever there are roads," Oden said.