5 ways providers can deliver better care to LGBT consumers
According to The Joint Commission, lesbian, gay, bisexual and transgender (LGBT) patients, as a group, have been largely disregarded as healthcare consumers until recently. Inequitable laws have made it difficult for them to obtain access to health insurance. LGBT partners or parents are often not considered family members according to hospital policy; therefore, they are not included in discussions about the patient's health and face restrictions on caregiving, visitation and medical decision-making.
Hospital providers and staff may also be unaware of key disparities between LGBT patients and the general population, such as higher substance abuse rates, higher rates of anxiety and depression, a higher incidence of HIV/AIDS and an increased incidence of certain cancers.
In a Field Guide about communication, cultural competence and patient- and family-centered care for the LGBT community, The Joint Commission says that "discrimination and mistreatment have, in many cases, contributed to a long-standing distrust of the healthcare system by many in the LGBT community and have affected their health in profound ways."
So, what can hospitals and physician practices do to ensure they're LGBT-friendly? Here are five suggestions:
1. Create a welcoming environment
Baligh Yehia, MD, MSHP, a Philadelphia infectious diseases specialist who chairs the American Medical Association's Advisory Committee on LGBT issues, told American Medical News that creating a welcoming environment for LGBT patients can enhance patient-physician communication. "As a physician, I want my patient to feel very comfortable," Dr. Yehia said. "That's very important when you're discussing very sensitive, personal information. On the flip side, the same thing goes for the patient. They want to feel like they're going to a doctor they can trust, and that they won't be judged if they share various things that may be important to their physical and mental health." Some strategies proposed by The Joint Commission for creating a welcoming environment for LGBT patients include posting the hospital's nondiscrimination policy or patient bill of rights in a prominent area, providing LGBT-relevant brochures and other reading materials, posting LGBT-friendly symbols (e.g., rainbow flag, pink triangle) and providing unisex restrooms.
2. Revise policies with an eye toward lifting unreasonable LGBT restrictions
Review your policy regarding visiting hours and make sure it is inclusive of same-sex partners and LGBT parents. Include partners and parents in patient education sessions and in medical decision-making, as allowable by state law.
3. Provide staff education
Include education about LGBT patients in your cultural competency training. Offer staff and provider education on potential health disparities in the LGBT patient community.
4. Facilitate patient disclosure of sexual orientation and gender identity
Some strategies proposed by The Joint Commission include making sure all forms contain inclusive, gender-neutral language and allow for self-identification; using neutral and inclusive language in patient interviews and listening for verbal cues (e.g., references to "partner").
5. Assist LGBT patients with obtaining insurance
In a Bernard Health blog post, Ryan McCostlin suggests some things hospitals can do to help patients find insurance, including enlisting the help of "navigators," recruiting existing staff to become certified application counselors, hiring Medicaid enrollment vendors, providing patient referrals to licensed health insurance brokers and partnering with licensed, non-commissioned advisors.