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Excerpt
Studies show that many lesbians and gay men have experienced discrimination by health care providers, and thus they often avoid even routine health care for fear of discrimination. Homophobia and lack of adequate knowledge about their unique health care issues among health care professionals result in inadequate care for many.
For physicians to provide culturally competent health care to vulnerable populations, including lesbians and gay men, they must receive adequate education. Educating physicians about these issues would reduce some of the barriers patients face when interacting with the health care system and would place physicians in a better position to care for their lesbian and gay patients.
We developed a seminar to address several goals related to these concerns: (1) to introduce medical residents at Rhode Island Hospital to lesbian and gay health care issues, (2) to allow residents an opportunity to discuss their own experiences with lesbian and gay patients, and (3) to give residents the tools necessary to conduct a sensitive interview in order to create a safe health care environment for their lesbian and gay patients.
Description: We are in our second year of conducting a three-hour seminar addressing lesbian and gay health care issues. The curriculum is divided into specific learning experiences aimed at the goals given above. The curriculum consists of (1) didactic instruction about the historical medical treatment of lesbians and gay men; (2) small-group discussions exploring the barriers to health care for lesbians, gay men, and other underserved populations; (3) review of a videotape entitled Tools for Caring about Lesbian Health, which addresses many of the barriers lesbians face when trying to seek health care, followed by discussion1; (4) didactic instruction outlining the unique health care issues of lesbians and gay men, with specific suggestions for how health care providers can create a safe environment for their gay and lesbian patients; and (5) case discussions, including an adolescent struggling with sexual identity, the difficulty of dealing with the loss of a partner, and domestic violence among gays and lesbians.1 We conclude with open discussion of any remaining issues.
Discussion: We developed a survey to assess whether the seminar made residents more prepared to care for lesbian and gay patients and to allow residents to evaluate the components of the seminar. Overall, 96% (22/23) felt more prepared to care for lesbian and gay patients after the seminar; 70% (16/23) rated the seminar outstanding, with few suggestions for altering the format, and the rest rated it excellent. We plan to invite several lesbian and gay patients to participate in the seminar, sharing their health care experiences with residents.
