In lieu of an abstract, here is a brief excerpt of the content:

Chapter 14 Missed Opportunities for Patient Education and Social Worker Consultation at the Arbor Free Clinic Marie Soller Lars Osterberg Astaggering 43.6 million Americans were uninsured in 2002, according to the United States Census Bureau. Uninsured patients frequently rely on free clinics for health care because they are often unable to use other clinics in their communities. Physician contact, patient education materials, and social worker consultation are among the important health care opportunities that free clinics offer. The limited availability of volunteer staff and donated medical supplies often restricts the range of health care services that free clinics are able to provide to their patients. Free clinics must strive to make the most out of available resources by making them accessible to their target clientele and ensuring that patient satisfaction is high. Missed opportunities are instances in which patients do not receive care that they desired and/or had an apparent need for. The occurrence of missed opportunities is often high in underserved patient populations; those documented in the literature include health screening, vaccination,, STD and pregnancy counseling ,, and breast-feeding education. Low-income, minority, and uninsured patients who do not receive health education materials and social worker consultation may be missing essential services that free medical clinics are able to provide. Providing printed health education materials is a relatively inexpensive and feasible service that may strengthen physician–patient communication and promote self-care., Social worker consultation provides low-income patients the opportunity to apply for public insurance programs and other services. Previous research suggests not only that missed opportunities might exist for receiving patient education materials and social worker consultation but that clinics are more likely to miss opportunities to provide these services for certain groups of patients than for others. Hispanics typically use fewer general health services than whites, perhaps because many Hispanics face cultural or language barriers to receiving health care that whites do not face. Blacks, Hispanics, and Marie Soller, MD, is a psychiatrist at the Wildwood Psychiatric Resource Center, in Beaverton, Oregon. Lars Osterberg, MD, MPH, is director of Educators 4 CARE and a clinical associate professor of medicine at Stanford University School of Medicine. Missed Opportunities for Patient Education and Social Worker Consultation 155 Asians have been shown to have more difficulty than whites in communicating with providers and understanding health information. Language differences between provider and patient constitute an important barrier to health care efficacy . Therefore, clinics may more frequently miss opportunities to serve patients who need an interpreter during the medical visit or who are from a culture different from that of their health care provider. In addition to making health care services accessible, free clinics, like all other medical care facilities, must attempt to promote the satisfaction of patients. Patient satisfaction has been studied in detail in the settings of Medicaid programs in general and Medicaid-managed care programs specifically.– No less important is the satisfaction of patients in free and volunteer clinics, although satisfaction has not been sufficiently studied in this health care setting. The objectives of our study were to (1) measure overall levels of patient satisfaction , (2) investigate whether the free clinic missed the opportunity to provide desired or needed patient education materials or social worker consultation, and (3) determine if certain groups of patients were more susceptible to missed opportunities than others. Methods A cross-sectional survey was conducted among 210 patients who presented over an eight-month period at the Arbor Free Clinic in San Mateo County, California. Arbor is managed by Stanford University medical students and staffed entirely by student and physician volunteers. The clinic was created to address the immediate health care needs of the underserved in the south San Francisco Bay area, who have few other options for accessing health care. Arbor provides medical services, gateway access to county social services, and health education materials in several languages. The Arbor Free Clinic has operated for more than 10 years with the goal of providing quality health care to its underserved community. Until recently , Arbor had yet to conduct a substantial evaluation of its patient care. A two-part survey was designed to meet the specific aims of the study. The survey was approved by the Stanford University Human Subjects Review Board, and administered over an eight-month period. Research volunteers, who were not regular clinic staff, offered participation in the study to all patients as they entered the clinic. Patients were assured that their responses would be anonymous and would not influence...

Share