Access to dermatology services at free medical clinics: A nationwide cross-sectional survey

Abstract

a simple, random sample of 357 of the total of 1280 clinics was selected. Clinics that, by their name, were obviously not medical (ie, dental or podiatric) were excluded. Data collection consisted of a 10-item survey administered by telephone from April to August 2018. This study was reviewed by the Augusta University Institutional Review Board and designated as not human subjects research.The results are summarized in Table I. Of the 357 clinics called, 137 (38%) did not answer after 3 attempts over 2 weeks and 62 (17%) were closed or did not provide medical services. Of the remaining 158 clinics, 54 (34%) declined to participate in the survey and 104 (29% of all the clinics called [66% of eligible clinics]) participated. Of the 104 participating clinics, 29 (28%) did not offer dermatology services or referrals, 58 (56%) referred patients to local dermatology practices for presumably discounted care, and 17 (16%) had board-certified dermatologists periodically available on site. At the free clinics with dermatology services on site, the average wait time was 21.6 days (standard deviation, 20.7 days). On-site dermatology services included biopsy services (available at 88% of the clinics), pathology services (available at 82%), and surgical excision services (available at 59%).At the 58 free clinics that refer patients to outside dermatology practices, the average volume of referrals was 1.9 per month (standard deviation, 3.9 per month). Contact information was provided by the free clinics for 13 referral dermatology practices, which were contacted to assess their willingness to accept referrals from free clinics. Of those 13 practices, 12 indicated that they

The Importance of Service Learning in Dermatology Residency: An Actionable Approach to Improve Resident Education and Skin Health Equity

“…8 In a dermatology access study, a sample of clinics listed in the National Association of Free and Charitable Clinics database were contacted regarding the availability of dermatologic care; however, more than half of the sites were unresponsive or closed, and the remaining clinics offered limited access to dermatology services. 9 The scarcity of free and low-cost dermatologic services likely contributes to adverse skin health outcomes for patients in underserved communities. 10 By increasing service learning within dermatology residency training programs, access to dermatologic care will improve for underserved and uninsured populations.…”

Considering patient preferences for student observation in free dermatology clinics

“…1 Dermatologic care offered at free clinics is generally limited and may not include biopsy, pathology, or surgical excision services. 2 Free clinics are often associated with academic medical centers, and both involve trainees in patient care. Also, many free clinics require medical students for administrative and other purposes.…”