Abstract Rationale Academic medical centers have concurrent responsibilities to train clinicians and provide patient care, particularly for underserved populations, while remaining financially solvent. These priorities are not easily aligned and can incentivize workflows that perpetuate health disparities. While there are documented discrepancies in care delivery and patient satisfaction among trainee and faculty primary care clinics, it is unknown whether these disparities are present in medical subspecialty clinics. Objectives We aim to analyze the quality of care metrics in a fellow-run and attending-run pulmonary clinic at a large academic medical center. Methods This is an observational mixed-methods study with balanced sampling between fellow and faculty clinics to ensure representation of marginalized populations. Patients completed a multi-component survey probing patient satisfaction and social desirability, as well as open-ended survey questions on treatment access and experience. Clinic metrics on vaccination rates, smoking cessation counseling, and lung cancer screening were abstracted from the electronic medical record. Measurements .05 for all tests); however, Latiné participants, particularly primary Spanish speakers, reported more difficulty accessing their respective clinic (average = 4.83 out of 5; versus 4.33, P = .02). Qualitative analyses revealed three response themes: systemic barriers to care, minimization of lived experiences, and supportive or positive encounters. Conclusions Despite infrastructure limitations in our trainee clinic, there were no significant differences in standards of care and patient satisfaction among fellow and faculty clinics were comparable. Further studies may elucidate gaps in patient experience and care delivery as experienced by patients and clinicians.
Regalia et al. (Fri,) studied this question.