Many members of LGBTQ+ communities do not trust doctors, hospitals, or the health system in general.
Only 17% of patients in LGBTQ+ communities trust the health care system, a recent report found. survey Through Healthgrades and Outcare Health, which provides resources for LGBTQ+ communities.
Many LGBTQ+ individuals haven’t seen doctors in years because they expect to be treated poorly, said Dustin Nowasky, president and founder of OutCare Health.
“There is a large body of research that shows that many LGBTQ+ people avoid going to providers and health systems, either because of past experiences they’ve had, or because of past experiences they hear from friends. families and colleagues,” says Nowaskie.
“I can tell you from my own clinical experience, as a provider, I get this feedback all the time from my patients… I’ve had many patients tell me I’m the first provider they’ve seen in over 20 years. 20 years ago because of something that negatively impacted them from another provider,” says Nowaski, a psychiatrist.
right now, Health standards We’re partnering with OutCare Health to make it easier for the LGBTQ+ community to find providers they can trust. Healthgrades has launched a new LGBTQ+ “Affirming Care designation” on it. website. Healthgrades is incorporating OutCare Health’s “Outlist,” more than 3,500 LGBTQ+ affirming providers.
Nowaskie said the partnership with Healthgrades could be an important step toward getting more people into care.
In an interview with Chief Healthcare Executive®Nowaskie will discuss the importance of providing better care for LGBTQ+ patients, the need for more education for providers to provide affirming care, and how health systems can better serve their LGBTQ+ patients and staff.
(Watch part of our conversation with Dustin Nowasky of OutCare Health in this video. The story continues below.)
‘Distrust and Dissatisfaction’
LGBTQ+ patients have long had concerns about the health care system, and many of those concerns are well-founded, Nowaskie says.
“Lack of trust and dissatisfaction is pervasive throughout the health care ecosystem,” says Nowaski. “We know that for too long there has been a lot of distrust in providers and specialists.”
According to a Healthgrades/Outcare Health study, more than half (54%) of LGBTQ+ patients trust their primary care physicians, compared to 70% of transgender patients. Additionally, only 16% of LGBTQ+ patients trust pharmaceutical companies and 15% trust insurance companies.
“It’s very clear to me, these systems don’t validate LGBTQ+ identities,” Nowaskie says. “They did not represent their LGBTQ+ employees. They are not talking about their LGBTQ+ members and their patients. And sadly, LGBTQ+ people know they don’t feel heard, represented, or validated.
of Human rights campaign He declared a “state of emergency” for LGBTQ+ individuals in the United States, citing dozens of discriminatory measures signed into law across the country. Nowaskie calls it a public health crisis.
“The gap between LGBTQ+ people is not diminishing,” says Nowaskie. “And in many cases, they come out on top.”
Some LGBTQ+ individuals have avoided going to doctors for years, delaying treatment for certain conditions or health issues that may have been addressed in the past.
“Many LGBTQ+ people don’t get annual routine checkups. And they often delay care for many, many years,” Nowaski says.
Many health care providers have received no training or education in serving LGBTQ+ patients. Doctors and clinicians who want to become certified should take the time to attend training, Nowaskie says.
However, Nowaski says it’s important to understand that “it’s a long journey.”
“In any case, one cannot guarantee any type of health care with one-and-done training,” says Nowaski.
“It requires a very long process of formal and remedial education,” says Nowaski. Some of our research shows that a provider probably needs at least 40 to 50 hours of LGBTQ+ education.
For providers who want to build trust with LGBTQ+ patients and feel more comfortable talking about their health, Nowaski says, “The best advice I can give is practice, practice, practice.
Psychiatrist Nowaski asks patients how they want to be called and which pronouns they prefer. Nowaskie also asks non-judgmental questions with gender-neutral language, inviting patients to talk about themselves and their lives.
“They’ve created this minimal cozy environment, and it’s a great way to build that relationship,” Nowaksie says. “And you want to ask these questions that you find for LGBTQ+ people. When someone asks in a very assertive way, they feel empowered to speak about who they are.
Some providers may feel uncomfortable asking questions, but LGBTQ+ patients may be more open to sharing than they expect.
“LGBTQ+ people want to be questioned,” says Nowaski. “It’s part of who they are as people, it’s who they are, it’s something they care about. It’s how they navigate the world and their places.
“Often they want to deliver this information because it’s so important to them,” says Nowaski.
Integrating LGBTQ+ care
Many health systems are working. Diversity, equity and inclusion High priority. Nowaskie said some efforts regarding LGBTQ+ communities are scattered or relegated to June, which is “Pride Month,” but don’t continue throughout the year.
Health systems must make a sustained commitment if they want to improve care for LGBTQ+ patients, Nowaskie says.
Hospital and health system executives should be involved in those efforts.
“LGBTQ+ people represent everyone,” Nowaskie says. “They all represent identities. They represent all conditions, all health outcomes, and so you should always, always, always integrate LGBTQ+ care into every effort you make as a hospital system. It is not a specific topic.
Health systems must consider the entire patient journey.
“It’s not just health care workers themselves,” Nowaski said. “It’s really everything. It’s the physical location. It’s the building, it’s the security inside the hospital and outside the clinic. So you really have to talk about the whole journey from someone’s home to the actual health care facility or organization.”
Health systems need to think about how patients enter the facility, how they are greeted, and how they feel during and after the visit. Providers and staff should use preferred pronouns and greet patients in a welcoming manner.
Hospitals also need to participate in ongoing training, Nowaskie says.
“It’s a long way to go, especially for health systems training and education, but not just for provider training,” Nowaskie says.
“Providers absolutely need the training,” Nowaski adds. But all the staff should be trained, the people at the front desk, the people who take the calls, the nurses, the social workers, the people who help take the basics, everybody has to be trained… Now, the providers probably need a little more in-depth training. Clinical training, but everyone needs the basics.