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Safety net clinics across the country struggle with a lack of resources to tackle the needs presented. Screening programs set up for children and elderly have proven to be effective in triaging need, prioritizing care, and maximizing resources. These programs do not currently exist for working uninsured adults. Research was initiated to answer the question: Does the screening process improve patient care for the community clinic? During a 6-week pilot study a licensed dental hygienist performed 30 screenings in the community clinic setting. Findings were recorded and coded according to patient’s level of need identified. Pre- and posttest data for patient care factors were attained. Statistical tests showed a significant effect on patient care factors. While the evidence existed to support the implementation of screening, more research would quantify the specific impact on this population.

Compared to the general population, socially disadvantaged patients have higher rates of chronic illness and require more complex medical care. They also endorse higher levels of psychological distress and tend to engage in behavioral risk factors such as poor diet, physical inactivity, and smoking. These issues are particularly concerning given that this population tends to adhere less to medical recommendations, has limited access to health resources, and receives poorer treatment from providers. In an effort to address this disparity, The Affordable Care Act will expand health care access to an additional 23 million uninsured and 17 million underinsured Americans. However, simply expanding access to health care without examining and improving upon factors related to the physician-patient relationship would not fully address the health care needs of this population. This study sought to improve the quality of care received by socially disadvantaged patients by better understanding the role of race and gender on the physician-patient communication process and patient outcomes in a safety net primary care clinic. The study sample consisted of 330 low-income, uninsured/underinsured African American and White patients and 41 resident physicians. Overall, African American patients and their doctors and White doctors and their patients were viewed as engaging in the highest levels of communication. South Asian physicians, and male South Asian physicians in particular, had the lowest levels of communication and the patients of these providers experienced less improvement in their physical health. Patient education level influenced physicians’ perceptions of their patients to the extent that patients with higher educational levels were viewed as engaging in lower levels of communication. Last, indicators of a good physician-patient relationship were associated with higher levels of patient reported adherence. Practice implications and areas for future research are discussed.