Abstract
In the United States, a physician or midlevel provider may be providing care to anywhere from 10-25 patients per half day. Health care providers, support personnel, and ancillary staff are pushed to the limits every day to care for patients with very limited resources and little available time. Matters of productivity and reimbursement dominate the health care system and determine the quality of care patients receive. This system is based on the assumption that the patient has an identified payer source and the means to obtain necessary health care. 3 In addition, the dominant model for care assumes that the patient's literacy level allows him or her to navigate through the system's voluminous red tape and to act as his or her own advocate. Health care organizations, hospitals, and community health centers have made a virtue of necessity as they creatively design programs that fit the needs of not only the organization but, most importantly, the patients. 4
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