Physician, Teach Thyself

A group of medical students are creating kits to help doctors learn about and provide better care for their LGBTQ patients.

I have been receiving some version of health care for 20 years as an out gay person. Thinking back to a sexual-health question I asked a provider in the ’90s and her bewildered response, I would say Madison has improved.

We are certainly not done.

Perhaps some of the “oops” moments have gotten more sophisticated, yet I must say something the next time a provider asks my partner about whether she is safe at home…in front of me. Assessing for intimate partner violence? Check! Doing so in a way that allows a person in a same-sex couple to feel safe answering? Fail.

On my long list of hopes is better training for mainstream medical providers. James Lehman, second-year medical student and Master of Public Health candidate at the University of Wisconsin School of Medicine and Public Health, and his student organization PRIDE in Healthcare have taken a significant step toward this effort. Thanks to a generous grant from the Dane County Medical Society, this spring PRIDE in Healthcare designed and distributed LGBT-Friendliness Kits for Primary Care Physicians to 300 physicians in Dane County. I met James when he did a project at the AIDS/HIV Program. Here’s what I learned from James about the project.

First off, where can our readers find the kit?

They can download it on our blog! It’s free for sharing, sending, and printing

How did you decide who would receive the kit and what to put in it?

We had quotas for certain specialties. Most physicians were primary care (over 80% were in pediatrics, internal medicine, or family medicine), but a number were psychiatrists and other specialists. Because the kit includes opportunities to register in publicly accessible LGBT-welcoming provider registries both in OutReach in Madison and in a national registry by the Gay and Lesbian Medical Association, we wanted to identify welcoming physicians on different health plans and at different facilities. Finally, we wanted at least 50 of the physicians to be outside of Madison.

As for what to include, we knew we had to address making clinics VISIBLY friendly, connecting community members with welcoming and affirming physicians, helping physicians identify misconception and bias in themselves and in others, and making physicians aware of the available evidence and guidelines about best practices for sexual and gender minorities. We ended up including a list of myths and misconceptions; a checklist; a glossary; a summary of local and national resources for continuing education, treatment guidelines, and social services; a faux pas guide; a decal; and the directory registrations.

What gap in available LGBT materials do the kits fill?

Our angle was that we cared about bringing information to physicians rather than waiting for them to find it. The kit is visually appealing, concise, cohesive, and respectfully honest about the fact that the status quo of physicians’ awareness about LGBT health is inadequate. Rule #1 was to make concepts digestible enough that physicians could identify clear goals for change.

Overall, not a lot of LGBT materials hit the sweet spot for this particular audience, who are short on time and have many competing priorities when seeing patients. Physicians are usually well intentioned but can be ignorant or shortsighted, just like anyone else.

What types of responses are you getting to the kits?

We get responses in two ways: the evaluations that are included in the kit and direct correspondences. These have been largely positive, from thanking us to asking for additional coverage of specialty-specific issues (pediatricians seem to want more targeted materials about adolescents). Some components appear to be useful to physicians depending on their experience; others useful regardless of their experience; and some only useful in very specific settings.

What can I do if I know a provider, primary care or otherwise, who could benefit from a kit?

You can download it, print it off, and take it to your own physician. Or send it to your physician by mail, either anonymously or with a personal note from you. You could also direct your physician to the link I shared.

What’s next for this project?

First, an addendum on adolescent health. We are also in talks with Sexual Assault Nurse Examiners (SANE) about an addendum for sexual assault and intimate partner violence. I want to tailor something to care of LGBT older adults as well. And we will likely expand kit distribution to Milwaukee next. If I am not completely depleted at that point, I may host a special LGBT health lecture for local physicians.

Thanks, James! It’s great to hear that this project will expand, due in part to feedback, and that the topics of sexual assault and intimate partner violence in LGBT relationships are getting more attention. n

Molly Herrmann is an activist, researcher, trainer, and consultant on LGBT intimate partner violence (IPV) with Humble Pie Consulting. She also currently works as a health educator in the state AIDS/HIV Program.