The issue of disparities in medical treatment between LGBTQ+ people and non-LGBTQ+ people has been widely recognized in recent years. Healthcare professionals have increasingly acknowledged that there is no one "right way" to provide care for all patients, particularly those who identify as lesbian, gay, bisexual, transgender, queer or questioning.
Implicit Bias
Implicit biases can result from unconscious attitudes, beliefs, and stereotypes that healthcare providers hold about LGBTQ+ individuals. These biases may be based on social norms, cultural values, and personal experiences. They often operate outside of conscious awareness and affect decision making processes.
An implicit bias could lead a provider to assume that a same-sex couple would make poor parents or that transgender individuals are struggling with their gender identity.
Training Programs
To address these issues, many healthcare institutions have developed training programs aimed at reducing implicit bias among staff members. These programs typically involve education around topics such as sexual orientation and gender identity, recognizing microaggressions, and providing culturally competent care. They also offer opportunities for reflection and discussion on how to improve care delivery.
Structural Inequities
In addition to implicit biases, structural inequalities can present barriers to receiving quality healthcare for LGBTQ+ people. This includes lack of access to affordable insurance coverage, limited availability of LGBTQ+ friendly providers, and difficulty navigating complex systems of care.
Some medical practices may not accept Medicaid or Medicare reimbursement, leading low-income LGBTQ+ individuals to seek care elsewhere.
LGBTQ+ patients may experience discrimination when seeking mental health services or accessing substance use treatment.
Solutions
There is no one solution for addressing structural inequities and implicit bias in healthcare.
There are several steps that healthcare organizations can take:
1. **Hire more LGBTQ+ professionals** - Encouraging diversity within the workforce can help create a culture where all patients feel welcome and comfortable. Healthcare institutions should actively recruit LGBTQ+ employees across disciplines, including nurses, social workers, physicians, and administrative staff.
2. **Offer training on cultural competency** - All staff members should receive education about working with diverse populations, particularly those who identify as LGBTQ+. This can include seminars, webinars, and continuing education courses.
3. **Improve patient navigation** - Providing assistance with appointment scheduling, transportation, and follow-up care can reduce barriers to care. Many hospitals have developed LGBTQ+ patient navigators who provide guidance through the healthcare system.
4. **Collect data on disparities** - Tracking metrics such as rates of access to care, satisfaction with care, and outcomes can identify areas for improvement. This information can inform decision making around resource allocation and policy changes.
5. **Collaborate with community partners** - Partnering with local LGBTQ+ advocacy groups and other stakeholders can strengthen relationships and foster trust between providers and patients.
How can healthcare institutions address structural inequities and implicit bias to improve care for LGBTQ+ patients?
Healthcare institutions are beginning to recognize that sexual orientation and gender identity may impact patient outcomes. Acknowledging this fact is an important step towards improving equitable treatment of LGBTQ+ people, but it is not enough. To truly address structural inequities and implicit bias, healthcare providers must undergo specific training on how to treat LGBTQ+ patients with respect and dignity.