Caring for diverse populations: do academic family medicine practices have CLAS?

BACKGROUND AND OBJECTIVES The Future of Family Medicine Final Report calls for greater emphasis on training physicians to provide culturally proficient and effective quality care to an increasingly diverse population. It remains unclear, however, how prepared academic family medicine practices are to address this need. METHODS We carried out a qualitative sub-study (as part of a larger research study) using depth and focus group interviews at two urban family medicine centers to understand the challenges and opportunities involved in meeting the Department of Health and Human Services Office of Minority Health's National Standards for Culturally and Linguistically Appropriate Services (CLAS) in Health Care. The Lewin Group's Organizational Cultural Competence Assessment Profile was used to analyze the qualitative interview data. RESULTS The main themes that emerged from interviews with faculty physicians, administrators, staff, and patients were: (1) the need for more linguistically appropriate services, (2) lack of communication among those involved in care delivery, and (3) interest in education about cultural and linguistic competence. CONCLUSIONS The academic family medicine practices studied are frustrated and challenged to integrate cultural and linguistic competence into patient care. Organizational pressures, multiple competing demands, and resource constraints inhibit preparedness to address the CLAS standards and important new national requirements and guidelines.