Blind as a bat.

Today was OK, I suppose. I went to the bathroom during our morning break and as I was taking off my glasses to fix my hair, one of the temples snapped right off. :( I've got fairly bad myopia and astigmatism and, without my glasses, I'm one of those people who can just sort of vaguely see something where the eye chart is supposed to be, so needless to say, this made for an interesting remainder of the day. I'd be lying if I said it didn't put me in a bit of a bad mood -- it's really hard to talk to people, especially people you don't know well, when you can't see their faces -- but I tried my hardest not to let it get to me.

The content of today was really very good. We had great speakers who talked about:

• the Tuskegee experiment and its implications on health care for African-Americans, especially in research
• Health care issues of Latino populations, especially the Hispanic or Latino paradox
  
• Health care issues of Asian-American/Pacific Islander populations (with an emphasis on Hep B)
• The obesity epidemic, especially as related to African-Americans

Many of the speakers shared their families' experiences with health care disparities and how they influenced their careers as physicians and it really was very moving. In the afternoon we visited a community clinic (which was a FQHC, or federally qualified health center). This clinic is part of an association that operates more than 40 community clinics in the Chicagoland area and is the largest such provider in the US. They provide care to anyone who walks in the door, regardless of their insurance status. For uninsured patients, they charge a sliding scale fee, which at the bottom is $15 per visit and includes anything that can be done at the clinic, including lab work. Approximately 25% of the patients this organization serves are uninsured, which works out to about 70,000 people per year (There are about 46 million uninsured people nationwide, of which about 1.2 million are in Illinois -- 860,000 of those are in the Chicago area.) They are able to fund this care because of a special arrangement (due to their FQHC status) with the government in which they are reimbursed extra money for every Medicaid patient that they see. They also receive grants and donations. None of my practice experience has been in underserved areas and so I had never heard of this program before, and the learning was time very well spent.