Table 3.

Barriers to care: subthemes and representative quotes

Subtheme by Zip-Code Income	Illustrative Quote
Provider knowledge gaps
High	“I ended up with fifteen doctors . . . and only one of them knew anything about sarcoidosis” (group 2, participant 3).
Low	“Medical doctors should know something about sarcoidosis so when a patient do come into their office, ‘I got this terrible cough,’ because a lot of doctors, in my own experience, they never heard of sarcoidosis” (group 4, participant 1).
Poor patient–provider communication
High	“You can be taking medication that ‘Hey, you know this doesn’t really work for me’ and no one’s listening to you” (group 2, participant 4).
Low	“I think the appointment were more depressing for me cause you gotta keep going to the doctor and don’t nobody got an answer and it’s just ‘take this medicine’” (group 4, participant 4).
Cost of care
High	“That [medication] had to be approved [by the insurer] and so that added another six weeks or so [to waiting for symptom relief]. I was feeling pretty bad because I had been that long without that medication that was helping [my symptoms]” (group 1, participant 3).
Low	“I’m [paying] $1,738 a month for my prescriptions” (group 5, participant 2).
Mistrust: quality of care
High	“He [the doctor] answered a lot of my questions, but . . . I had a knot in my stomach when I left his office because . . . he wanted me on like all kind of steroids and I’ve never been on a steroid” (group 1, participant 3).
Low	“I was on those pills. The doctor never even consulted me about them, and the next thing I know, I’m getting all these hip pains” (group 4, participant 5).
Mistrust: income-based discrimination
Low	“I don’t think I get the same as someone that can afford it” (group 4, participant 3).
Low	“Don’t nobody care about me, but me . . . if you never had to go to the doctor, they don’t make any money off of you . . . I don’t want them to get rich off of me” (group 5, participant 2).
Mistrust: racial incongruity
Low	“My doctors are Caucasian, so I can’t talk to them the way I want to talk to them . . . it’s just like they’re just there” (group 3 [low income], participant 1).
Low	“I’ve had bad experiences with some doctors. I don’t know if it was racial, but they treated me different when I did ask them questions, like ‘who are you?’” (group 5, participant 5).

Mistrust related to income-based discrimination and racial incongruity were unique barriers for patients from low-income zip-code areas.