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By C. Jayden Smith

The residents of San Clemente did not find a permanent solution to the debate about health care within the city limits, but a community roundtable on Saturday morning, April 23, brought about discussions from multiple demographics.

A small assemblage of around 30 gathered in the auditorium of the San Clemente Community Center, treated themselves to refreshments and split into three tables to talk through their opinions and concerns.

In addition to residents, one doctor and one hospital operator were assigned to each table, to provide a different perspective and answer questions.

Mayor Gene James and Mayor Pro Tem Chris Duncan, who comprise the City Council’s Hospital Subcommittee, meandered about while people spoke, hoping to get a glimpse into participants’ mindsets.

The meeting format was designed to differ from the typical idea of a forum in which public speakers only have a short, designated time to talk.

“That wasn’t the idea today,” said Ryder Smith, who moderated the session. “The idea is to have long format conversations with actual doctors, actual hospital operators, because it’s a very complex space.”

Following introductions and a replay of the city’s video summarizing San Clemente’s health care history, each table had around 30 minutes for discussion. The topics ranged from estimates about the true cost of building a new hospital to personal anecdotes about health care experiences with nearby facilities.

To finish, representatives from the three groups—residents, doctors and hospital operators—spoke about their conclusions.

Here are a few points each group made:


  • There was concern regarding the requirement of using a credit card at urgent care clinics and the troubles that people without a credit card face as a result.
  • Some felt it was important to save five to 10 minutes of time in getting a patient to a facility in San Clemente as opposed to the Providence hospitals in Mission Viejo or Laguna Beach.
  • A group discussed the lack of patient volume that led to the former MemorialCare hospital’s closure and lack of transparency about how much money the facility had lost.
  • “Our emergent care needs are still an issue and what acute services are needed … to support those is still part of the puzzle,” said Mike Clark, speaking for his group who concluded that urgent care was not the most immediate solution.
  • There was a desire to see urgent care hours extended past the normal 8 p.m. or 9 p.m. closing time.


  • An urgent care that essentially is an emergency room in everything but name was suggested, including high-quality physicians and staff and appropriate equipment.
  • Dr. Robert Realmuto, an emergency physician, wanted the city’s goal to involve improving population health, the concept of individuals having access to necessary services in regards to unscheduled care.
  • Realmuto added that if all stakeholders are involved, that a pooling of money would result in people getting the care and access they need at a fraction of what they think it would cost.

Hospital Operators

  • “One point that I would like to get across is that for you to have really good quality care, we need to have sufficient volume going through that facility,” said MemorialCare Medical Foundation CEO Mark Schafer.
  • Brian Fuller, director of strategy and business development for Providence Mission, talked about bringing in high acuity urgent care services and agreed to the notion of expanding their hours. From Providence’s perspective, he said they look at health care as an ecosystem that involves primary and specialty care, urgent care, and first responders, and needs to have the ability to care for the underinsured and uninsured as well.
  • Beyond emergency services, Robert Braithwaite, president and chief executive officer of Hoag Memorial Hospital Presbyterian, said that the community must be prepared to provide specialty care and technology that can better serve the city’s growing population, and must always be thinking ahead. He mentioned cities such as Foothill Ranch and Huntington Beach that have involved the community and partnered with organizations that helped them progress toward improved services.
  • “It’s not just theoretical,” Braithwaite said. “It’s very purposeful planning that has structure and content tactics, and they’re marching in a very healthy and thoughtful way.”

During the closing comments, James continued to push for looking at outpatient care in San Clemente as the health care industry changes.

He echoed a comment made by a resident earlier in the session, regarding how in football, a quarterback needs to throw to where his receiver is going, not where the receiver is located at the time.

“I think we have to throw the ball where this is industry is going,” James said. “The health care payers … are pushing people out of the hospital.”

C. Jayden Smith

C. Jayden Smith graduated from Dana Hills High in 2018 before pursuing a Bachelor’s degree in digital and broadcast journalism from the University of North Texas. After graduating in December 2020, he reported for the Salina Journal in Salina, Kansas. Jayden loves college football and bothering his black lab named Shadow.

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