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APHA Scientific Session and Event Listing

Recorded presentation

Anne Peneff Albert, DC, Dipl Ac, Evanston-Rogers Park Family Health Center, 1555 W. Howard Street, Chicago, IL 60626, (773) 764-7146, dralpalbert@yahoo.com

OBJECTIVES: I described my participation in the chiropractic pilot project of the National Health Service Corps (NHSC) at two Chicago area clinics. I focused on patients without health insurance and challenges encountered therein. METHODS: I used data from my employer's billing department, Access Community Health Network, and patient files to analyze uninsured patients I saw from August, 2003, through July, 2005. Analysis was by gender, race/ethnic group, age, marital status,number of children, occupation, household income and prevalence of lumbar disc disorders. RESULTS: Typical uninsured patients were male Latinos, early thirties, married or co-habiting, with three children, employed in moderately heavy manual labor jobs, with household income of less than $20,000 and higher prevalence of lumbar disc disorders than the general population. Patients' challenges included unfamiliarity with Worker's Compensation laws, delaying treatment and decreased treatment frequency. Physician's challenges included patients' reluctance to take off work, delay in referral by the primary care doctor and providing "crisis" rather than comprehensive care on the initial patient visit. CONCLUSIONS: Uninsured patients and their chiropractic physician face numerous obstacles in the current health care system; patients cannot access health care services on a timely or regular basis, and the physician is duty-bound to help patients obtain medically necessary treatment, often "by any means necessary". Systematic program development on all levels -- patient-doctor, clinic, community, region, state and federal -- is desperately needed to overcome these obstacles and improve patient care.

Learning Objectives:

• Describe a typical chiropractic patient without health insurance in Chicago.
• Discuss challenges that both the chiropractic patient and provider encounter.
• List strategies used to treat the uninsured chiropractic patient.

Keywords: Chiropractic, Underserved Populations

Related Web page: www.accesscommunityhealth.net

Presenting author's disclosure statement:

Any relevant financial relationships? Yes

Organization	Clinical/Research Area	Type of Relationship
Access Community Health Network	Chiropractic, acupuncture	Employment (includes retainer)

Any company-sponsored training?	No
Any institutionally-contracted trials related to this submission?	No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

Recorded presentation