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Adequate LGBT Healthcare Requires Inclusion, Openess

Herry Lawford

Dr. Stephen Nelson first became aware of the LGBT healthcare disparity through another boundary that frequently occurs between doctor and patients--race. The director of the Sickle Cell Clinic at Children's Hospitals and Clinics of Minnesota, he found his patients shared a common thread.

"It's a global disorder but in North America virtually all the patients are black as a result of the Atlantic slave trade. I began to notice our patients all have very different stories, as all of our families do, but they all have one thing in common: none of them are white, and the vast majority of the healthcare team is."

That, he said, could affect relationship building between doctor and patient--an essential component to trust and effective healthcare. 

"In healthcare, because we tend to be under heavy cognitive load--we're very busy, we have rooms full of patients, we have other demands upon our time, the electronic medical record and other issues. And our schedules are ripe for defaulting to stereotyping. And we like to categorize people, and if we can skip our answer more quickly then it's more efficient. It takes hard work to identify that we are functioning at the level of our unconscious biases and to really stop that process."

So he began to work on overcoming those barriers, both with race and with sexuality. He says openness and resisting subconscious assumptions is essential, but that's not as common of a practice as he'd like it to be.

"Unfortunately there's not a lot of training in medical schools and nursing schools around issues of bias and humanism and connection. [...] Cultural humility is one way to think about that. It certainly holds true with LGBT issues. But it is very important."

In this hour of River to River, host Ben Kieffer speaks with Dr. Stephen Nelson; Dr. Richard Deming, radiation oncologist and Medical Director of Mercy Cancer Center in Des Moines; and Ryan Sallans, LBGT speaker, consultant, and author of the book Second Son.

Ben Kieffer is the host of IPR's River to River