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BCMS – TOGETHER
WE STAND

The Importance of

Dermatologic

Access for Lower

Socioeconomic

Communities

By Christina Pierce, Rebecca Wang
and Tue “Felix” Nguyen

What role does low socioeconomic status have in access to fourth Tuesday of every month, between 3:45 to 6:00 pm and is a walk-
care for dermatologic conditions? in clinic with an effort to see all patients who need care. Travis Park
Dermatologic complaints are common in the United States, with 85 also serves as a valuable learning opportunity for medical students, they
million patients in 2013 visiting physicians for their skin complaints. are able to manage the dermatologic concerns of many patients by con-
Dermatologic care can help reduce mortality and hospitalization for ducting focused skin histories, and physical exams and reporting their
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patients with skin conditions. However, access to dermatologists is findings to the present dermatology residents and attendings. The team
widely variable and dependent on many factors such as poverty, rurality, then formulates a treatment plan with the patient’s financial situation
insurance status, age, sex and travel burden. One study found that poor, in mind. Therefore, free clinics serve as a resource that increases acces-
near-poor, and low-income individuals were less likely to have a der- sibility to quality care and enriches the medical school curriculum by
matology visit in one year compared to middle-income individuals. allowing students to assess and treat patients holistically.
Additionally, uninsured patients or those with Medicaid or Medicare While Travis Park is an excellent opportunity for patients with lower
had fewer odds of visiting the dermatologist than privately insured pa- income or unstable healthcare to address their skin complaints, many
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tients. Based on the 2020 Census, 17.6% of the San Antonio popula- still encounter barriers that prevent them from seeking care. Some of
tion are persons in poverty, and 19.3% of individuals under the age of these barriers include lack of transportation, mistrust of the medical
65 in San Antonio were without health insurance. Lack of health in- system, other time constraints and language barriers. Additionally,
surance and lower income decrease the likelihood of these individuals knowledge of these free clinics may not be available to everyone in San
receiving dermatologic care. Dermatological conditions and diseases, Antonio who may benefit from visiting these clinics.
such as squamous cell carcinoma and melanoma, are prevalent. Lower
socioeconomic status (SES) creates a barrier for patients to seek and What can we do to improve access?
receive the care or treatment they need. Fortunately, there are student- An idea we suggest to improve accessibility and address barriers to
run free clinics affiliated with UT Health San Antonio that are of no care would be establishing more operating clinic locations in the San
cost to those seeking care and serve as a resource to address dermato- Antonio area, especially in communities that lack healthcare. This
logical concerns. However, we are advocating that awareness of these proposition could be accomplished by using a geographical mapping
free clinics be more widespread to inform patients who would benefit tool such as PHATE to identify lower SES regions that may greatly
from visiting. benefit from having a clinic nearby. Once the clinic locations have been
chosen, students and faculty will set a date and time to provide consis-
Where are these clinics located, and what do they offer? tency. For example, the free clinic will be open on the first Wednesday
Travis Park Dermatology Clinic is a free dermatology clinic run by of every month at 3:00 pm at the south side location and on the third
students and faculty within the UT Health San Antonio system lo- Wednesday of every month at 3:00 pm at the downtown location. This
cated in downtown San Antonio. This clinic is open on the second and scheduling would provide more opportunities and options for patients

16 SAN ANTONIO MEDICINE • January 2023