Western Journal of Emergency Medicine: Integrating Emergency Care with Population Health

Introduction: There is evidence that healthcare providers are lacking in knowledge and confidence when it comes to treating LGBT+ patients.

Objective: To assess providers’ LGBT+ health-care knowledge, willingness to treat LGBT+ patients, communication behaviors, and whether there is a need for additional training. This involved an assessment that measured respondents’ knowledge of LGBT+ patients’ reluctance to communicate with providers, risk for certain cancers, and risk for suicide. Secondary outcomes assessed providers’ attitudes and practices toward LGBT+ patients.

Methods: 16 physicians and 24 nurses in the emergency department of an urban Level 1 trauma center were asked to participate in a survey regarding LGBT+ health. The survey was modified from published work and included questions about transgender patients. The effects of age, gender, and type of provider were contrasted with their willingness to treat and knowledge of LGBT+ healthcare. Descriptive statistics, Fisher’s exact test, and the Wilcoxon rank-sum and Kruskal-Wallis tests were used. This study was approved by the IRB and all data was de-identified.

Results: Compared to nurses, physicians were 9.0 (95% CI: 2.09–38.79) times more likely to agree with the statement “LGBT+ patients avoid accessing healthcare due to difficulty communicating with providers” (p=.003). Further, providers under the age 45 had a higher level of agreement with the statement “There should be more education in health professional schools on LGBT+ health needs” (p=.03) and with “being listed as an LGBT-friendly provider” (p=.001), as did nurses (p = .04) and those who identify as LGBT+ or know someone who identifies as LGBT+ (p=.005). Finally, respondents reported higher agreement to the statement “There should be educational events at my hospital about LGBT+ health needs” (Mdn=4, IQR=3–5) than to “I am well informed on the health needs of the LGBT patients” (Mdn=2, IQR=2–3).

Conclusions: There is a need and desire for educational events at the professional school and provider level, in addition it is recommended to conduct an educational intervention.