The Community Health Clinic Experience: How Staff Deal with Daily Pressures

When I began this qualitative methods project in Fall 2006, I anticipated being able to speak directly to patients in community health clinics to understand whether or not patients’ cultural beliefs and behaviors influenced their care and treatment. From the literature and from personal experience overhearing patient-provider exchanges in an emergency waiting room, I had a preconceived notion that Latina/o patients and their providers experienced challenges in communicating with each other. Despite several attempts to strike up conversations in community health clinics with the women waiting to be taken to exam rooms, I was only able to informally interview one teen-aged patient who has only visited a community health clinic once since emigrating to the U.S. a year ago. Instead, I focused on learning more about community health clinic staff experiences.

Observing and interviewing patients without an introduction or common ground proved challenging. Conversely, speaking with and observing community health clinic staff, especially at the Spanish Catholic Center in Langley Park, MD, proved an eye-opening experience. From discussions in semi-structured and formal interviews, staff members find working at a community health clinic to be challenging but immensely fulfilling. They consider themselves to be dedicated and caring people who, despite funding issues, lack of resources, and low salaries, provide quality health care and treatment for their community members who are uninsured and underserved. For most people I interviewed, working at a community health clinic fulfilled their personal mission. They felt they provided quality health care, although two providers, including a physician assistant and nurse disagreed. 

I’d like to conduct more semi-structured interviews with community health clinic staff. I have more questions about the challenges of working in and I’d like to learn more about working with and serving patients and their needs. And I’d like to observe patients in exam rooms and interview them about their health care experiences. Ultimately, I believe my research can be used to help develop “best practices" for community health educators. This is still very much a new idea for me, but one I plan on testing out through the next year and a half.

If I had the time and capability, or worked on a team project, I would be very interested in comparing the experience patients have in community health clinics and private practices or hospitals. I did get a taste of the differences two health professionals had in working at both levels, and from their discussion, it appeared as though the differences were striking, with quality of health care and treatment being a primary division, and funding and resources being contributing factors. Although ethnicity was not discussed, these two health professionals were white, middle-class educated women who do not live in the same community where they practiced at their community health clinics. I am interested in exploring this disparity more, as well as interviewing patients who have also had experiences in the community and private sectors.