Implementation of a novel otolaryngology clinic for indigent patients. (10th July 2013) - Shuman, Andrew G.
Abstract : Objectives/Hypothesis: This study was designed to describe the implementation, utilization, and outcomes of an otolaryngology clinic for indigent patients employing a novel design. Study Design: Pilot study. Methods: A tertiary‐care academic otolaryngology department partnered with a nonprofit outpatient clinic for indigent patients in order to provide free subspecialty consultation services. A novel format was utilized in which the department provided on‐site, scheduled outpatient multidisciplinary consultation on weekends, staffed by volunteer health care providers and ancillary staff. A review of the program was conducted using prospectively collected data. Clinic design, staffing, utilization, and feasibility were described, along with demographic and clinical data for all patients participating in the clinic from October 2010 through January 2012. Results: Five clinics were held over 15 months, totaling 74 patient visits, with positive feedback regarding accessibility and quality of services provided. A total of 60 procedures were performed, including audiograms, endoscopies, otologic procedures, biopsies and/or excisions. The estimated value of medical services that were provided was $37, 302. Four potentially life‐threatening conditions were newly diagnosed. Twenty patients received conclusive evaluation and treatment at the time of their first visit. Eighteen patients required further subspecialty treatment and/or surgery that could not be provided in the outpatient setting, and were referred appropriately. Conclusions: The partnership between an academic otolaryngology department and a nonprofit clinic provided free on‐site consultation for indigent patients. Such an arrangement is feasible, well utilized, and successful in delivering comprehensive specialized services to indigent patients who lack traditional access to medical care. Laryngoscope, 123:2142–2147, 2013