Patient-centered care requires considering your patients’ wants and needs in their management. ALL patients deserve person-centered care.
The modern healthcare climate doesn’t look the same as it did twenty years ago when I began my practice as a nurse in the Deep South. Primary care providers knew their clients, rounded on them at the hospital, and followed them throughout their lives. In the contemporary world of fragmented care, this patient-centered approach is supported in the empirical literature, but it’s harder to build trusting, long-term relationships with patients. This is true particularly with LGBTQ patients.
LGBTQ people are at high risk for health disparities, and failure to disclose is often because of a lack of trust and fear. This disparity has increased amid the global pandemic and LGBTQ individuals face even more challenges. According to the Human Rights Campaign’s (HRC) recent research brief, more than five million LGBTQ folks are more likely to work in jobs that place them at higher risk for COVID-19. LGBTQ people have higher rates of poverty, more frequent gaps in healthcare coverage, and 37% of LGBTQ adults abuse tobacco products compared to 27% of non-LGBTQ people.
When supporting patients who identify as LGBTQ, healthcare professionals must:
1. Build rapport by inquiring about pronouns.
Then, take the time to explain your inclusion policies or practices. Also ask about the person’s willingness to establish a long-term relationship and describe the benefits of this.
2. Assess for health determinants.
Obtain a full health history, including sexual history, social support network, employment history, economic status, health insurance status, screen for depression and suicide risk, and ask if they use drugs.
3. Offer specific LGBTQ resources.
Check out www.outcarehealth.org for state-by-state LGBTQ-centered resources and offer to make referrals as appropriate.
4. Create a patient-centered plan.
Work with your patient to establish a plan that works for them, not for you. This vital step ensures ongoing self-efficacy and improved health outcomes.
5. Follow-up with your patients.
Nothing builds trust like following up when you say you will. During the COVID-19 pandemic, take full advantage of the telemedicine for easy follow-up.
Providing culturally appropriate inclusive care to LGBTQ people amid the global pandemic can save LGBTQ lives and is achievable through person-centered care.