More hospitals earn good grades for LGBT-friendly policies
■ CMS and the Joint Commission bar discrimination against LGBT patients. Some hospitals are going further to make these patients and their families feel welcome.
By — Posted July 29, 2013
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This year has seen a sharp rise in the number of hospitals adopting policies aimed at ensuring equality in the treatment of gay, lesbian, bisexual and transgender patients, physicians and other health professionals, according to a report issued in July.
A record 718 health care facilities, mostly hospitals, participated in the Human Rights Campaign Foundation's "Healthcare Equality Index" in 2013, up from 407 facilities in 2012. The foundation is the nonpartisan arm of the Human Rights Campaign, a gay-rights advocacy group in Washington. There are 5,724 registered U.S. hospitals, according to the American Hospital Assn.
More than 80% of hospitals taking part in the voluntary survey scored well on the foundation's criteria. The report grades respondents on whether their policies bar discrimination against LGBT patients and employees, including physicians and other health professionals. To score well on the index, those policies must be communicated to patients and employees.
One huge chunk of the index's new participants came from the Veterans Health Administration. Eighty percent of the health system's 151 medical centers took part in the index this year.
"The VA as an organization was looking at our environment for LGBT veterans following the repeal of 'Don't Ask, Don't Tell,' " said Uchenna S. Uchendu, MD, the VHA's chief officer for health equity. In addition to participating in the "Healthcare Equality Index," each VA medical center was encouraged to implement initiatives to improve care for gay patients and families. Some hospitals, for example, have appointed LGBT coordinators to address these patients' concerns.
The VA "serves veterans irrespective of who they are," Dr. Uchendu said.
Survey respondents also are graded on whether their policies explicitly grant visitation rights to LGBT patients and families and whether those policies are communicated. For a perfect score, facilities must offer online training to all of their executives and staff on issues specific to care and treatment of this patient population. For example, lesbians have a higher risk of breast cancer than heterosexual women, likely due to higher rates of smoking, alcohol consumption and excess weight.
The training — offered at no charge by the HRC Foundation — also focuses on how to address transgender patients, same-sex couples and family members in a courteous, respectful and sensitive manner. For example, individuals who have changed their gender should not be addressed by the pronoun corresponding to their sex at birth.
Hospitals with perfect scores earn designations as "leaders in LGBT health care equality." In 2013, 212 earned that mark of distinction, up from 71 in 2012.
Goal is a comfortable environment
The overarching aim of the index is to encourage hospitals to create an atmosphere where LGBT patients feel comfortable being themselves during times of great stress, said Shane Snowdon, author of the equality index and director of the HRC Foundation's Health and Aging Program.
"There's no time when we're more vulnerable than when we're going into the hospital," she said.
Lesbians have a higher risk of breast cancer than heterosexual women.
Creating a welcoming environment for gay and lesbian patients can enhance patient-physician communication, said Baligh Yehia, MD, MSHP, a Philadelphia infectious diseases specialist who chairs the American Medical Association's Advisory Committee on Gay, Lesbian, Bisexual and Transgender issues.
"As a physician, I want my patient to feel very comfortable," Dr. Yehia said. "That's very important when you're discussing very sensitive, personal information. On the flip side, the same thing goes for the patient. They want to feel like they're going to a doctor they can trust, and that they won't be judged if they share various things that may be important to their physical and mental health."
The AMA has policies opposing discrimination against physicians, medical students and patients on the basis of sexual orientation or gender identity. In 2011, the Centers for Medicare & Medicaid Services said hospitals that want to participate in Medicare must bar discrimination in visitation based on sexual orientation or gender identity. The Joint Commission also issued a standard in 2011 calling for LGBT-friendly nondiscrimination policies.
"Healthcare Equality Index 2013," Human Rights Campaign, July (link)
Copyright © 2013 American Medical Association. All rights reserved.
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