Kirsten Hartwick, MS4

Patients often experience unforeseen barriers when walking into a hospital – expensive parking, lackluster food, delays in care and scheduling conflicts. The suggested solutions are numerous, but often for a patient, the impact is unseen at best or minimal at worst.

These unforeseen concerns as a patient can be even more challenging if a patient identifies as lesbian, gay, bisexual, transgender or queer (LGBTQ). Imagine a patient named Loretta Jones. Loretta lives in Union Hill, has two daughters, works in human resources and is a transgender woman. Loretta was biologically born a male, but she identifies as female and transitioned when she was in her mid-40s and is currently taking daily hormones. Just like so many patients before her, Loretta walks into the hospital hoping to receive medical care, but she is unable to see over the barriers hospital systems too often place in front of their patients.

Walking into her new primary care provider’s office, someone at the front desk welcomes her to the office and asks for her insurance information. The name on Loretta’s insurance card does not match the name on her driver’s license, and Loretta is asked how that could possibly be. She finally makes it into see her provider, who stumbles through Loretta’s medical and surgical history, unclear as to how to discuss her history in a productive and respectful manner. This is unlikely to be the last instance in Loretta’s encounter with the medical system in which she is made to feel uncomfortable and unwelcome.

We can and need to do better for patients like Loretta. A study done in 2006 found that close to half of LGBTQ patients from Worcester seek their medical care outside of Worcester. LGBTQ patients in Worcester need a voice and a medium to enact change within their health care system.

Through my experiences at UMass, I founded a LGBTQ Patient and Family Advisory Council (PFAC) at UMass Memorial HealthCare, the largest health care system in Worcester County. Currently, there are a number of Patient and Family Advisory Councils (PFACs) at UMass, which are improving patient care through patient-driven discussions in a variety of different areas, including pediatrics, oncology and psychiatry. A LGBTQ-specific PFAC would address the concerns and needs of LGBTQ patients within the UMass medical community.

Many individuals describe incidences of discrimination, either at their primary care doctor’s office or when they seek emergent services at a hospital emergency department. Others describe not wanting to have to educate their providers about their health needs. Furthermore, certain services, including hormone replacement therapy and gender-affirming services, are not readily available to adult patients in the Worcester community.

Efforts are being made to rectify these deficits, but patients need to be part of the process. By understanding patient needs and including patients as part of strategic discussions, targeted initiatives and invested resources will best address the needs of the LGBTQ population in Worcester County.

Efficacious clinical care starts with an understanding of population health and ends with a tailored, empathetic approach that is specific to each patient.

If you are interested in learning more or joining the PFAC, please email us at LGBT.PFAC@umassmed.edu.

If you have questions, comments or story ideas, email john@johnart.com.