The Estacada Development Association would like to see an Affordable Health Clinics practice open in Estacada. So would the city manager.

So would Affordable Health Clinics founders Cecilia and Dr. Rob Tilley.

There’s just one thing keeping that from happening. After approximately six months of searching, they have not yet found a doctor or nurse practitioner to run the clinic.

The Tilleys opened Affordable Health Clinics in Tigard in November 2011.

Fed up with the culture of corporate medicine, they decided to run the clinic on an alternative model.

They don’t take health insurance, charge a flat fee of $77 per visit, and Dr. Tilley sees no more than three patients an hour.

“We act as a family practice so people who can’t afford a doctor can have their own doctor,” said Cecilia Tilley, who leads the clinic’s marketing efforts.

Providing adequate time for doctor-patient interactions is a big benefit to both patients and physicians in the Tilleys’ model.

“What we find is (many) physicians hate what they do. They have six-minute visits. They’re paid on productivity and work 60-70 hours a week,” Cecilia Tilley said of typical general practitioners.

Rob Tilley has been practicing medicine for more than 20 years. For years he provided medical services to correctional facilities.

Tilley owned his own practice that treated incarcerated patients, but sold it to Conmed Healthcare Management in 2008.

He continued as vice president of the Northwest Operating Region of Conmed before the Tilleys decided to “go rogue” and open the Tigard clinic.

Cecilia Tilley told of two instances that demonstrated the need for affordable health care and inspired she and her husband to start Affordable Health Clinics.

One day, their son dislocated his thumb while Rob Tilley was out playing soccer.

Cecilia Tilley took her son to the emergency room, and it cost her “$1,250 just to walk in the door.”

They walked out with a $2,000 hospital bill.

Incidentally, during Rob Tilley’s soccer game, he treated the same injury (at no charge) on the field.

Another time while waiting in line at a pharmacy, the Tilleys watched as a young couple heard the high cost of a prescription. The couple looked at each other and back at their children and drove away without the medicine.

Though the Tilleys had considered going to India to lend their talents there, they realized there was a huge need for affordable healthcare here in Oregon.

A few months after getting the idea for Affordable Health Clinics, the Tilleys opened the doors of their Tigard practice.

It had been a risky move.

They decided early on they wouldn’t accept health insurance.

Cecilia Tilley explained that it costs an average doctor thousands of dollars a year to accept health insurance. The Tilleys decided to simply charge a flat fee per visit instead.

Some, assuming that most people would have health insurance under ObamaCare, told the Tilleys their practice would fail if they didn’t accept health insurance.

But it didn’t.

Cecilia Tilley estimates the clinic sees around 3,300 patients.

Roughly 20 percent of their patients actually have insurance, but their deductibles are so high that they choose to use the clinic.

The clinic commonly treats diabetes, hypertension, rashes, cancer and acute pain and provides pain management services. Dr. Tilley often performs minor surgeries such as cyst, mole and toenail removal.

“It’s a family practice, so we see a little bit of everything,” Cecilia Tilley said.

Cecilia Tilley promises that the clinic helps their patients get “great rates for imaging and labs” through partnerships with Epic and Quest laboratory services.

The clinic has so many patients that the Tilleys are in the process of hiring a part-time nurse practitioner to help out.

They sold their “big house on the hill” in Newberg to subsidize the clinic.

“We’re going from living large to living little,” Tilley said. “A big house makes for a big mortgage. Now we are able to take less money out of the practice so we can now afford another practitioner.”

Patients travel from all over to be treated at Affordable Health Clinics in Tigard.

“We do have several patients from Estacada. We have people travel a long way. We have patients from Coos Bay,” she said.

They have so many patients, it has been hard to find time to search for a doctor or nurse practitioner to run an Estacada location of the clinic.

Tom Wille, an Estacada Development Association (EDA) board member, can’t wait until they do.

Wille learned of the Tilleys when he read an article about them after they opened Affordable Health Clinics in Tigard in late 2011.

“It seemed to me we had a real need for more health care in Estacada,” Wille said, noting that at the time, Estacada’s only two general practitioners, Dr. Richard Orth and Dr. Edward Rambousek, weren’t accepting new patients.

Wille said Estacada residents often have to drive to Sandy or other cities for healthcare and that the lack of nearby doctors makes Estacada a less enticing place to move.

This is a major concern for the EDA, as it is charged with attracting new business to Estacada.

When Wille read of Affordable Health Clinics, he thought it would be an ideal practice to bring to Estacada.

So did EDA Chairman Phil Lingelbach.

Because Estacada “is demographically blue collar,” Lingelbach said, a lot of residents don’t have health insurance and would be drawn to a clinic that simply charges a flat fee of $77 per visit.

Wille and Lingelbach got in touch with the Tilleys and brought them to Estacada for a tour and a meeting with then-Mayor Becky Arnold, City Councilor Sean Drinkwine and City Manager Bill Elliott.

All involved seemed excited about the project, Wille said.

“We’d certainly welcome it. There’s obviously a need that’s not being met at this particular juncture, so I’m sure we would love to see it happen,” Elliott said recently.

The only problem: finding a doctor or nurse practitioner to run the Estacada clinic.

Wille believes the difficulty in doing so is due to not having the word out.

He sees numerous benefits for a doctor or nurse practitioner interested in running an Affordable Health Clinics location in Estacada.

“A doctor who comes here will get to be part of the community. He’ll get to meet (patients) one on one,” he said. “A doctor gets to be a doctor.”

Wille owns the Mason Building in downtown Estacada and hopes that if the space is still available, the clinic will open in the spot previously occupied by Estacada Music.

However, he emphasized that bringing more health-care options to Estacada is his main drive.

“Whether they locate in my building or not is secondary,” he said.

Wille and Lingelbach estimate that once a doctor or nurse practitioner is hired, the clinic could be up and running in a matter of months.

While initial interest in opening an Affordable Health Clinic office in Estacada was sparked prior to the opening of the Wade Creek Clinic, the Tilleys are no less keen on Estacada now.

“We knew about (plans for the Wade Creek Clinic) when we visited Estacada,” Cecilia Tilley said. “As most children have Oregon Health Plan (coverage), we don’t see many children.”

The Wade Creek Clinic is run by a nurse practitioner and treats students and community members.

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