How can we better improve care for LGTBQIA+ patients in and beyond the practice suite?
This discussion will provide insights on continuity of care, pain points in practice and also dive into how systems are implementing best practices for managing the data and patient experience of their LGTBQIA+ populations.
Concurrent to AMA celebrating Pride Month, our discussion catalyzes active and ongoing research which directly improves patient outcomes.
Join us here on #OurAMA Physician Innovation Network to learn & share best practices and spur critical dialog!
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As a gay male patient, I do not do anything special. I have had zero complexities navigating the health care system. I think that the caveat here is that as a physician, I have insight into how I need to navigate the system. I also have had the luxury of having employer based health insurance my whole life, whether on my parents plan (including during all of medical school) and then during my training and now as an attending. This gives me a large network of physicians to see. I have also been lucky that all of my doctors have been affirming, even though I do not screen for that ahead of time.
For many of our patients though, they are naive to the complexities of navigating the system or may be un/underinsured. This leads to reducing access to care.
Pending
I agree with Dr. Cooper. Persons working in the health professions generally know how to navigate complex health systems relatively safely and derive maximum benefit from them. Many trans persons really want to receive care from clinicians who have personal familiarity with their experiences. While I strive to make complex health systems more accessible and to locate "friendly" clinicians within them for trans patients seeking specialized or primary care, I also recommend going to a community-based health center that caters to their experience whether that is primarily an immigrant one, a trans one, or one that is more specific to race and ethnic identity. Of course, when healthcare is tiered like this, we have a more stratified health system that can perpetuate inequities.
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(My comments here are from the perspective of a primary care provider.) Working as a PCP in a medical home that is tailored for the LGBTQ community, I am able to provide primary care services in a supportive environment. When our patients need to step outside of our health center for care, though, we often struggle with unfriendly environments, unknowledgeable clinicians, mis-gendering, etc. When we do find supportive and knowledgeable specialists, the U.S. multi-payer system may limit who has access to these specialists. This feels especially urgent with behavioral health and with specialties that are very sensitive for LGBTQ patients (urology, for example.)
Although we can ask resources within the medical neighborhood about their experience and knowledge in caring for LGBTQ patients, it would be helpful to have a set of standards that are routinely re-assessed.
Pending
Navigating the US health care system can be daunting for LGBTQ+ patients (especially those who are coming out) who are trying to understand themselves, their bodies and how that relates to their health. Larger cities offer directories and resources for the LQBTQ+ community to direct patients to care providers that can address their needs. However, less populated areas/rural areas may not offer this as an option, so navigating the local health system could prove to be more difficult. Personally, I seek out resources for LGBTQ+ friendly providers as a way to ease navigation woes. This comes from past trial and error, having led to less than ideal scenarios.