Background: In Houston, Texas, half of Latinos are considered to experience ¿limited English proficiency¿ (LEP). Due to this and other barriers imposed by the US healthcare system, Hispanics are at a disadvantage and children represent an even more vulnerable group. The purpose of this study is to explore possible barriers related to access, language, and communication in terms of standard of care. Methods: For this hybrid study, data was collected through participant observation (assistant consultant in a pediatric outpatient clinic). The sample (N=157) was constructed by observing the first 6 visits daily for a month with the same provider. The duration, reason of consultation, interaction and number of questions were registered and correlated with their ethnicity using Rstudio Software, fieldnotes were also qualitatively codified to induce insights. Results: The total sample identified 45% of patients as Latino (indirect classification). Among this subgroup, 13% struggled with LEP. The 9 cases were women, representing 5.73% of the total population. Even though the clinic had access to interpreters, their service was never requested by either physicians or patients. There were no statistically significant correlations considering consultation time and ethnicity, however the average consultation time was 4:53 minutes, which poses questions to the quality of the service and a particular risk for satisfactory communication in LEP patients. Latino children were less frequently given analgesics after vaccination which suggests a differentiated standard of care. Conclusions: Limited consultation time is a major concern that may impede quality of care and worsen barriers with multicultural patients. While addressing structural aspects, health professionals should adhere to the Civil Rights Act, and patients should be better informed and feel empowered to demand translation services. Other research approaches that blend the patient¿s and physician¿s experience can help inform the complex interactions that may arise in order to prevent disparities in healthcare provision.
