Dr. Harvey Makadon of Fenway Institute
Photo: The Fenway Institute
By: Sara Brown/TRT Assistant Editor—
BOSTON, Mass.—Revolutionary medical guidelines on how to care for the LGBT community were released by the Association of American Medical Colleges (AAMC) late last year. Such guidelines are impacting the overall standard of care received by creating an inclusive environment for patients.
“This groundbreaking publication represents a major step forward in giving medical schools, teaching hospitals, and health systems a roadmap for improving the care of LGBT and other individuals with differences in gender identity, gender expression, and sex development,” said Darrell G. Kirch, M.D., AAMC president and CEO. [pullquote]“This groundbreaking publication represents a major step forward in giving medical schools, teaching hospitals, and health systems a roadmap for improving the care of LGBT and other individuals with differences in gender identity, gender expression, and sex development,” said Darrell G. Kirch, M.D., AAMC president and CEO.[/pullquote]
The guidelines have 30 competencies that future doctors must master, according to the AAMC. These competencies fall under eight major themes: patient care, knowledge for practice, practice-based learning and improvement, interpersonal and communication skills, professionalism, systems-based practice, interprofessional collaboration, and personal and professional development.
The AAMC began developing these guidelines in 2012 with funding from the Josiah Macy Jr. Foundation. The non-profit organization is dedicated to improving the health of the public by advancing the education and training of health professionals. The AAMC developed an advisory committee composed of medical education experts that helped develop these set of standards.
“Physicians and medical school faculty members are committed to treating all patients equally, yet research shows that everyone has unconscious biases that can affect how we interact with people from different experiences and backgrounds,” said Kirch. “This new resource will help train physicians to overcome these blind spots and deliver high-quality care to all patients.”
According to Mason Dunn, Executive Director of Massachusetts Trans Political Coalition, proper inclusive medical care to the LBGT community is vitally important. [pullquote]The guidelines have 30 competencies that future doctors must master, according to the AAMC. These competencies fall under eight major themes: patient care, knowledge for practice, practice-based learning and improvement, interpersonal and communication skills, professionalism, systems-based practice, interprofessional collaboration, and personal and professional development.[/pullquote]
“It’s not just about knowing the proper medical practices but also [about] being fully inclusive,” Dunn said. “If someone has repeated negative experiences they are less likely to seek health care.”
Dr. Harvey Makadon, Director of the National LGBT Health Education Center at The Fenway Institute, says one of most nerve wracking experiences for LGBT patients can be in the waiting room.
“Every frontline staff needs to be trained about how to ask people their preferred [way] to be addressed,” Makadon said.
This is especially true for transgender patients.
“Something as simple as an intake form can be overwhelming. Usually the first questions are what’s your name and what’s your sex, with only two options male or female,” Dunn said. “There are so many more experiences that are outside of those boxes.”
The Fenway Institute encourages doctors to use the right language to develop trusting relationships with their patients. For instance, they tell the doctor never to assume their patient has a partner of the opposite sex. Instead of asking “do you have a boyfriend or a husband?” ask “are you in a relationship?”
Also, the Fenway Institute suggests doctors correct their colleagues if they use the wrong name or pronoun when talking about a patient. This helps to create an environment of accountability. Mistakes will, however, be made from time to time. If a doctor makes a mistake, they need to acknowledge it and apologize, according to Fenway.
Makadon believes that doctors sometimes get overwhelmed with treating transgender patients because they think it is more complicated than it is. [pullquote]Also, the Fenway Institute suggests doctors correct their colleagues if they use the wrong name or pronoun when talking about a patient. This helps to create an environment of accountability. Mistakes will, however, be made from time to time. If a doctor makes a mistake, they need to acknowledge it and apologize, according to Fenway.[/pullquote]
“I think this is because so many doctors know so little about it that they assume it has to be complicated,” he said. “When it comes to something like hormonal therapy, it is no more complicated than birth control. Once you make that connection, it becomes very satisfying to help.”
Makadon said having an inclusive welcoming environment makes LGBT patients, especially transgender people, feel like they can keep coming back.
“The last thing you want is for someone to never to come back and just buy hormones over the phone and do it on their own,” he said. “The more you get comfortable with it, the easier it becomes.”
For more information on The Fenway Institute, visit: www.lgbthealtheducation.org. For more information about the AAMC guidelines, visit: http://offers.aamc.org/lgbt-dsd-health.
