Page 6 - Kansas Journal of Medicine, Volume 10 Issue 4
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KANSAS JOURNAL of  MEDI CIN E                              Table 1. Demographics of the rural Kansas family medicine
                                                                physicians surveyed.
     RURAL KS FAMILY PHYSICIAN SATISFACTION                                                            Number (%)
     continued.                                                  Gender

       A questionnaire (Appendix A) was developed to determine the       Male                             13 (72)
     demographics of the physician and details about his or her practice,       Female                    5 (28)
     including years in practice, practice setting, and percentage of His-  Age
     panic and SSO patients in their practice. Questions also were asked       30 - 39                    8 (44)
     about the physician’s level of Spanish-speaking ability, availability       40 - 49                  4 (22)
     of certified interpreters, and the physician-patient relationship with       50 - 59                 0 (0)
     SSO patients. Physicians were asked to rate their ability to provide
     care to their patients and the satisfaction with the care that they       > 60                       6 (33)
     delivered. They also were asked to distinguish this from their overall   Race
     professional satisfaction in regards to their relationship with SSO       White/non-Hispanic         15 (83)
     patients. Respondents remained anonymous.                       White/Hispanic                       2 (11)
       Descriptive analysis methods were used to determine details about       Asian                       1 (6)
     the survey respondents. Pearson’s correlation analysis was used to   Spanish-speaking ability
     assess associations between different survey response items.  All sta-      None                     2 (11)
                                                      11
     tistical analyses were performed using SPSS for Windows, version 23.      Basic ability              10 (56)

     RESULTS                                                         Good to advanced ability             6 (33)
        Eighteen questionnaires were returned from the 52 physicians
     sent questionnaires, resulting in a 34% response rate. Respondent   Table 2. Practice description of rural physicians surveyed.
     demographics are shown in Table 1. Seventeen (94%) of the physician   Solo practice                 1
     respondents self-identified as white and two (11%) respondents had a   Small group practice         5
     Hispanic, Spanish, or Latino heritage. Practice descriptions are noted   Medium to large group practice  1
     in Table 2. Of the eighteen physician respondents, seven engaged in   Hospital employed             7
     private practice (solo, small group, medium to large group), while the   FQHC, etc.                 3
     remainder were hospital employees or worked for a Federally Quali-  Other (retired)                 1
     fied Health Center (FQHC), rural health clinic, or other safety-net
     clinic. One respondent was retired, and his or her responses were   Table 3. Hispanic patients in practice.
     included in the analysis.
        Eleven physician practices had a Hispanic-patient population   Number (%) of Practices    % Hispanic Patients
     greater than 25% (Table 3). SSO patients comprised greater than        7 (39)                     10 - 25
     25% of the patients in only one practice (Table 4). Private practices   9 (50)                    26 - 50
     had significantly fewer patients who identified as Hispanic or Latino   2 (11)                    51 - 75
     [correlation analysis: r(17) = .49, p = .05] and significantly fewer SSO
     patients [r(18) = .62, p < .01]. A decrease in the number of patients   Table 4. Percent Spanish-speaking only Hispanic patients.
     who identified as Hispanic or Latino in the physician’s clinic corre-  Number (%) of Practices  % Spanish-speaking Only Patients
     lated with a more negative relationship with SSO patients [r(17) =     5 (28)                      < 10
     -.53, p = .02] and a decrease in professional satisfaction caring for this   12 (67)              10 - 25
     population [r(17) = -.56, p < .01].                                    1 (5)                      26 - 50
        If physicians were Hispanic or Latino, their perception of their
     ability to care for SSO patients was not an issue [r(18) = -.52, p =.03].   Table 5. Use of certified interpreter for clinical visits for
     Ten (56%) physicians claimed to have basic Spanish-speaking ability,   Spanish-speaking only patients.
     six (33%) noted good to advanced Spanish-speaking ability, and two   % of Encounters for All Practices   % of Time Interpreter was Used
     (11%) had no fluency in Spanish (Table 1).                            Surveyed
        If physicians did not speak Spanish, their perception of their pro-   78                         < 25
     fessional satisfaction with SSO patients was negative [r(18) = -.49,     5                         26 - 50
     p = .04], and, if they spoke Spanish, their perception of their ability   11                       51 - 75
     to care for SSO patients was positive [r(18) = .59, p = .01]. Certified   6                         > 75
     interpreters were underutilized during clinic visits. A certified inter-
     preter was used less than 25% of the time in over 75% of the clinical
     settings (Table 5).
  80
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