It is imperative that clinicians create a safe environment for patients to feel comfortable providing their medical history and receiving necessary medical care. Electronic Medical Records which allow patients the ability to identify themselves as LGBTQ can cue clinical providers to the patient’s potential needs and challenges. Clinician cultural competency can ameliorate the quality of patient interactions.
There have been continued reports of negative experiences by the LGBTQ community specifically as it relates to unequal healthcare treatment and homophobia. According to a 2010 study, a national survey of LGBT physicians, 65% of them reported hearing derogatory comments about LGBT patients from healthcare professionals. 34% of them reported witnessing discrimination in care against patients in the LGBT community.13
A 2011 survey of transgender people noted that 19% of survey responders reported being refused medical care because of their gender identity.14
The joint commission and the Institute of Medicine have both voiced that sexual orientation and gender identity should be included as part of the electronic medical record.15,16 Having this information in the electronic medical record is imperative for tracking and analyzing health disparities in the LGBTQ community at the population level.
Education of the medical community to become competent in the care of the LGBTQ community has been identified as the way forward in helping bridge the gap in the healthcare disparities affecting the LGBTQ community. There has been a push to include competencies in the medical and nursing curriculum which address issues surrounding sex, gender, sexuality, and other related topics.
Continuing medical education to nurses, physicians and other clinical providers on LGBTQ issues has become the best recourse given the sparsity of LGBTQ issues in the curriculum.
The Health Equality Index (HEI) is a benchmarking tool which was established in 2007 and is used to designate healthcare facilities in the United States which are leaders in LGBTQ healthcare equality.17
Despite the increased awareness of the need for a diverse and culturally competent workforce, there remains a glaring lack in the resources needed to train culturally competent providers. It has become obvious that cultural competency is an issue no longer relegated to the federal government, state governments or even healthcare organizations, but rather a central, fundamental issue necessary to provide appropriate healthcare in the 21st century. Nurses, as the largest group in the healthcare workforce, should continue to champion as patient advocates.18