UW fellowship aims to boost support for LGBTQ patients
The University of Wisconsin School of Medicine and Public Health will be the first site to host a new national fellowship that aims to make the doctor’s office more supportive of LGBTQ patients.
The school will receive $750,000 over four years from the American Medical Association Foundation to launch a training program for early-career primary care physicians to ensure LGBTQ people have access to a high standard of health care.
Research has shown that discrimination against LGBTQ people is associated with higher rates of depression, increased suicide risk and reduced access to preventive health care such as cancer screenings.
In the past year, 15% of LGBTQ Americans postponed needed medical care for fear of discrimination from their health care provider, according to an October 2020 study from the Center for American Progress, a progressive think tank based in Washington, D.C.
Many LGBTQ respondents have had other negative experiences with health care, the study found, including a provider being visibly uncomfortable with their sexual orientation (14% of respondents), harsh or abusive
language (8%) or unwanted physical contact (7%).
The outlook is worse for transgender people — a third of whom in the same study reported having to teach their provider about transgender people to receive appropriate care — and LGBTQ people of color, who often experience intersecting discrimination.
These results track locally: A 2019 study using data from the Survey of the Health of Wisconsin found lesbian, gay and bisexual Wisconsinites were twice as likely as their heterosexual counterparts to delay obtaining health care, and transgender residents were nearly three times more likely to report poor quality of care and unfair treatment by the medical profession.
UW-Madison’s fellowship program aims to turn those outcomes around. And while it’s first, the foundation’s website says it plans to support fellows at dozens of institutions over the next decade.
Dr. Elizabeth Petty, senior associate dean for academic affairs at the School of Medicine and Public Health, will serve as program director.
As a lesbian woman, Petty said she has had some negative encounters with the health care system.
“I’ve had some things that were said that were offensive or humiliating, things that were wrong in terms of making assumptions about my sexual activity ... not offering the kind of care I knew I needed as a physician,” she said.
She’s also part of Facebook groups for LGBTQ people in Madison to share which doctors will provide affirming care and which to avoid. It upsets her that affirming care isn’t a given.
The fellows who take part in this program are expected to help change that landscape. Petty said they plan to recruit nationally for early-career primary care providers who have a track record of health equity work.
The first year of the program, which will kick off in July 2022, will serve as a pilot year, with the goal of adding three fellows per year as its reputation grows.
It will be housed within the school’s Department of Family Medicine and Community Health, and fellows will do both clinical and classroom training in LGBTQ health topics and participate in research, teaching, mentoring and community engagement.
Research in particular will be critical to improving health outcomes for LGBTQ people, Petty said, because there’s so much left to be explored: the unique needs in rural communities, across intersections of race and ethnicity, and across a person’s lifespan, to name a few.
When fellowships conclude, doctors will have a variety of options at their fingertips, she said. They could stay on to do research or teach at UW, join a practice elsewhere in Wisconsin or even go on to be a “change agent” at the national level.
Petty said it’s exciting to be the first school chosen for the fellowship program, but that it’s even more exciting to picture a few years down the road, when there might be a strong network of programs improving the health care experience for LGBTQ patients across the country.
In Wisconsin, she feels the work will tie directly to the Wisconsin Idea — the notion that what’s learned at the university should be applied to solve problems throughout the state.
“We can change the shape of health care for LGBTQ people,” she said. “We’re here to serve.”