PORT ANGELES — It took a few weeks of treating Tanzanian villagers for David Kanters to realize he simply had to reopen CliniCare, the walk-in medical facility he shuttered Oct. 31.
“I realized I like health care, just not the bureaucracy,” Kanters, 62, said Monday, recalling the May 20-June 12 trip to the African nation that he took with Evangelical International.
The advanced registered nurse practitioner had closed the facility Oct. 31.
“The bureaucracy and dealing with the insurance was more than I could do myself,” he said.
So in reopening his 621 E. Front St. clinic by Aug. 1, he will address the paperwork issue by not taking insurance to avoid billing costs, he said Monday.
Medical care at the only privately owned walk-in clinic in Port Angeles will be paid for at the time of service.
Hours will be 9 a.m. to 5 p.m. Monday through Thursday, with appointment-only visits on Friday, after 5 p.m. Monday through Thursday and scattered through the week during regular hours.
Other steps to keep his overhead down will include employing only himself and an office manager instead of the nine people he had to let go when he shut down.
The clinic will provide patients with codes and forms at the end of their visits to file claims with their own insurance companies.
By cutting costs, Kanters expects to charge 40 percent less than what he billed patients in 2009-2010.
All his medical equipment is still at the clinic, but his medical records will be computerized.
“I surely don’t want to deal with hard records like I did before,” Kanters said.
Within a year, he hopes to hire a second health care clinician to expand office hours and cover for times he’s not available.
Kanters also will be working on a plan to deliver health care for $20 to $30 an office visit for patients who want or need regular follow-up visits rather than occasional office call.
“I just have fun seeing patients,” he said. “I don’t care if I make money at it. I’d like to break even, and I don’t think that will be a problem.”
It won’t matter that the federal government will require individuals to have insurance by 2014, he said.
“People will have to have insurance, but that doesn’t improve access,” Kanters said.
Cash for medical care is “a concept that’s kind of gaining,” he added.
“It’s sort of a throwback to my great-grandfather’s day.”
Founded by Kanters in 1989, CliniCare employed nine people, including two nurses, and saw between 35 and 45 patients daily before closing last fall.
While in Tanzania, “not dealing with reimbursement issues put the fun back in health care,” he said in a prepared statement.
“It has also become clear in the last three months that there was nearly as much need here as there is in Africa with the looming retirement of about four or more providers and very few prospects to take their place, the health care shortage will only be increasing in Port Angeles.”
While treating patients in Tanzanian villages, “we treated everything within our limited abilities,” he Monday.
“They were common things that happen to everybody — shingles, skin rashes, pneumonias, bronchitis, the kinds of things we treat every day here in the office,” Kanters said.
He also treated more exotic maladies, including malaria and bot flies, which lay larvae on human skin.
The larvae burrows into the skin.
“It’s kind of a gross little rascal,” Kanters said.
In the past nine months, Kanters has focused on search-and-rescue operations with the Clallam County Sheriff’s Department and training a dog.
He also took a road trip to Southern California to visit family.
A 1968-1969 Vietnam War veteran, Kanters also attended a reunion with his Army unit, the 173rd Airborne.
Throughout the hiatus, though, he was constantly approached by former patients who missed his practice and had no where else to turn.
Then, as Kanters was leaving Tanzania, a surgeon who was arriving there “said kind of an odd deal,” Kanters recalled.
“He said, ‘In the States, I get paid big bucks doing this kind of stuff, and I hate every minute of it.
“‘I go here and get paid nothing, and I love it.’”
Their conversation cinched it for Kanters, he said.
“It’s the patients’ bureaucracy that leads to burnout, not the patients,” he said.
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Senior Staff Writer Paul Gottlieb can be reached at 360-417-3536 or at paul.gottlieb@peninsuladailynews.com.