Caring for the underserved: using patient and physician focus groups to inform curriculum development.
BACKGROUND
Training pediatric residents to care for the underserved is a recognized curricular need. A literature review revealed that curricula specific to caring for the underserved tend to focus on specific medical diagnoses rather than physician or patient behaviors.


OBJECTIVE
To collect and evaluate information essential for developing a curriculum to teach care for the underserved.


METHODS
Focus groups were conducted to identify themes responsive to the question, "What does a physician need to know to care for the underserved?" Each of 3 focus groups met twice. The physician group included 5 pediatricians and 3 family practitioners. There were 2 patient groups: one Spanish-speaking (N = 13) and one English-speaking (N = 8). Content analysis was used to identify themes from each of the focus groups.


RESULTS
Prevailing themes from the 3 groups were communication/respect, cultural issues, and frustration with systems, such as health insurance, transportation, and health delivery systems. Patients expressed an almost universal wish for physicians to listen to them and to attempt to "understand my life." Physicians expressed concerns with lacking the time to establish quality patient relationships and the need to serve multiple roles. The groups did not discuss issues related to specific medical conditions.


CONCLUSIONS
Physicians and underserved patients identified communication/respect, cultural issues, and frustration with systems, such as health insurance, transportation, and health delivery systems, as important factors in caring for the underserved. Curricula to teach care of the underserved should include these themes.
Hobson
Wendy L
WL
Departments of Pediatrics, University of Utah, Salt Lake City, UT 84132, USA. wendy.hobson@hsc.utah.edu
Avant-Mier
Roberto
R
Cochella
Susan
S
Van Hala
Sonja
S
Stanford
Joseph
J
Alder
Stephen C
SC
Croskell
Sarah E
SE
D000328:Adult; D003142:Communication; D003479:Curriculum / Q000592:standards*; D005194:Family Practice / Q000193:education*; D005260:Female; D017144:Focus Groups; D006801:Humans; D008297:Male; D008507:Medically Underserved Area; D010372:Pediatrics / Q000193:education*; D010817:Physician-Patient Relations