title: Implementation of a novel otolaryngology clinic for indigent patients.
abstract: OBJECTIVE
  This study was designed to describe the implementation, utilization, and outcomes of an otolaryngology clinic for indigent patients employing a novel design.
  
  
  METHODS
  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.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University of Michigan Medical School, Ann Arbor, Michigan, U.S.A.
authors.forename: Andrew G
authors.initials: AG
authors.lastname: Shuman
authors.forename: Robbi
authors.initials: R
authors.lastname: Kupfer
authors.forename: Katherine
authors.initials: K
authors.lastname: Simpson
authors.forename: Jean
authors.initials: J
authors.lastname: Cederna
authors.forename: Paul S
authors.initials: PS
authors.lastname: Cederna
authors.forename: Paul
authors.initials: P
authors.lastname: Salow
authors.forename: Carol R
authors.initials: CR
authors.lastname: Bradford
authors.forename: Erin L
authors.initials: EL
authors.lastname: McKean
mesh_terms: D000046:Academic Medical Centers; D000293:Adolescent; D000328:Adult; D000368:Aged; D000554:Ambulatory Care Facilities / Q000458:organization & administration*; D005240:Feasibility Studies; D005260:Female; D006284:Health Plan Implementation / Q000458:organization & administration*; D006297:Health Services Accessibility / Q000458:organization & administration*; D006801:Humans; D008297:Male; D008489:Medical Indigency / Q000191:economics / Q000706:statistics & numerical data*; D008824:Michigan; D008875:Middle Aged; D009939:Organizations, Nonprofit / Q000458:organization & administration; D010036:Otolaryngology / Q000458:organization & administration; D010038:Otorhinolaryngologic Diseases / Q000175:diagnosis / Q000628:therapy*; D010865:Pilot Projects; D011203:Poverty; D016730:Program Development; D015397:Program Evaluation; D018570:Risk Assessment; D016896:Treatment Outcome; D055815:Young Adult
keywords: Free clinic; charity care; subspecialty consultation