A Tale of Two Health Clinics

2docs.jpgMeet Zubin Damania and Florence Jameson: Two physicians with plans for much-needed health clinics in downtown Las Vegas, whose respective business models reveal two distinct visions of the area—two different downtowns, for that matter.

Damania is the brains behind the Downtown Clinic, the health-care element of the Downtown Project, the multipronged revitalization effort funded by Zappos CEO Tony Hsieh. A 1999 graduate of UC San Francisco Medical School who did his internal-medicine residency at Stanford, Damania was working as a hospitalist at Stanford earlier this year when Hsieh persuaded him to move to Las Vegas and—in typically ambitious Hsiehian terms—help reinvent health care. You may know Damania by his rap alias, ZDoggMD.

Jameson is the founder of Volunteers in Medicine of Southern Nevada, which gives free health care to impoverished Clark County residents who have neither insurance nor eligibility for government-funded programs such as Medicaid. Jameson, an obstetrician/gynecologist, attended medical school at UCLA, did her residency at Cedars-Sinai and has been in private practice in Las Vegas since 1985. Having brought more than 5,000 babies into the world, she frequently introduces people by saying, “I delivered his [or her] son [or daughter].”

Besides West Coast medical educations, Damania and Jameson share other traits—in particular, a deep concern for patients and a desire to find a better, more just way to practice medicine.

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Jameson’s first Volunteers in Medicine clinic opened in 2010 at Paradise Park near the corner of Tropicana Avenue and McLeod Drive. It now has about 700 volunteers, including 40 physicians, who serve more than 2,500 patients. Now VMSN plans to build a 12,000-square-foot clinic downtown near Martin Luther King Boulevard and Washington Avenue. The nonprofit has raised about $445,000 of the necessary $3 million, mainly through its annual charity ball. (This year’s event is Oct. 6 at the Venetian. See VMSN.org for details.) Jameson says construction on the project can start when the capital campaign reaches $2.8 million—which she hopes will be within a year.

Volunteers in Medicine is focused on serving the indigent and working poor, patients who typically don’t have primary-care doctors and can’t afford preventive care. These patients, Jameson says, are often unable to afford treatment even at federally subsidized clinics such as Nevada Health Center’s recently opened Martin Luther King facility, which accepts Medicare and Medicaid and offers low-income patients sliding-scale fees.

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Where Jameson sees a chance to alleviate suffering, Damania sees an opportunity to change the way health care is delivered. In the battle for reform, he takes a hybrid approach, which he says is still evolving. Part concierge model and part network-referral service, Downtown Clinic would offer primary-care services through a paid membership, accepting no insurance.

Damania hopes to open the Downtown Clinic by the end of the year, most likely in a space near East Fremont. At the beginning, it will be a lean, mean startup, with just Damania and an intern on staff. The plan is to open a full-fledged clinic in a larger space next year. Startup fees will be picked up by the Downtown Project, but Damania hopes the clinic will eventually be self-sustaining.

Among the many hurdles he’ll have to clear to realize his dream, the trickiest may be setting appropriate membership fees—that means trying to get an advance sense of costs, number of patient visits and services provided. (Membership, he says, will be for everyone in the community, not just Zappos employees.)

While Jameson’s model is well established, the Downtown Clinic approach is a whole new formula, says Adam Higman, a consultant for health-care centers. The Downtown Clinic, he says, would give patients with jobs and health insurance a handy location for primary care at a fixed cost. The arrival of Jameson’s clinic, meanwhile, would mean that lower-income and homeless people—those often overlooked in downtown development—wouldn’t have to go to the UMC emergency room for routine care.

“If they both do materialize,” Higman says, “it sounds like a great benefit to the community.”

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