The objective of this study was to describe the population served at an episodic clinic in Southwest Virginia to better understand patient needs at a yearly episodic Remote Area Medical (RAM) clinic that provides free healthcare services. Methods: The dataset was compiled retrospectively from 2834 medical records from RAM patients between 1 July 2006 and 31 July 2008. Information was de-identified and manually recorded from paper records. The data were analyzed using descriptive statistics and

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... ompared to pre-existing estimates from the region. Findings: The number and type of services rendered at the RAM clinic each year varied greatly, and was dependent on the availability of staff and supplies. Diabetes, hypertension, and other prevalent diseases were reported, and an overwhelming majority (74%) of patients were overweight or obese. In 2008, 62% of patients were uninsured, 44% had no primary care physician, and a majority of patients were diagnosed with hypertension or poorly managed diabetes. Conclusions: Chronic diseases including obesity, hypertension, diabetes, and arthritis plague the Appalachian region. However, better knowledge of the medically underserved in this region can help address the patient's needs through RAM clinics and other accessible health clinics by increasing patient and physician awareness of available services, decreasing patient waiting time, and improving medical recordkeeping.