A growing, profitable internal medicine practice of 10 physicians, 2 physician assistants, a physical therapist, and a massage therapist is located in a city of 150,000 people. The clinical personnel are mostly from the majority group in the area and consider themselves open-minded, altruistic, and culturally aware. The administrative support staff is representative of the makeup of the patient population—mostly minority groups in the local community. The patient population is growing and becoming more diverse from those newly arrived in the city. The practice is currently facing several challenges.
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