AEM Education and Training 12: Attitudes, Behavior, and Comfort of Emergency Medicine Residents in Caring for LGBT Patients: What do we know?

Welcome to the twelfth episode of AEM Education and Training, a podcast collaboration between the Academic Emergency Medicine E&T Journal and Brown Emergency Medicine. Each quarter, we'll give you digital open access to AEM E&T Articles or Articles in Press, with an author interview podcast and links to curated supportive educational materials for EM learners and medical educators.

Find this podcast series on iTunes here.

DISCUSSING (CLICK ON TITLE TO ACCESS):

Attitudes, Behavior, and Comfort of Emergency Medicine Residents in Caring for LGBT Patients: What Do We Know? Joel Moll MD, Paul Krieger MD, Sheryl L. Heron MD MPH, Cara Joyce PhD, Lisa Moreno‐Walton MD

LISTEN NOW: INTERVIEW WITH FIRST AUTHOR Joel Moll, MD, FACEP

Joel Moll, MD, FACEP

Residency Program Director

Associate Professor

Department of Emergency Medicine

Virginia Commonwealth University School of Medicine

Abstract

Background

Although lesbian, gay, bisexual, and transgender (LGBT) patients are ubiquitous in emergency medicine (EM), little education is provided to EM physicians on LGBT health care needs and disparities. There is also limited information on EM physician behavior, comfort, and attitudes toward LGBT patients. The objective of this study was to assess EM residents behavior, comfort, and attitudes in LGBT health.

Methods

An anonymous survey link was sent to EM programs via the Council of Residency Director listserv. The primary outcome of the 24‐item descriptive survey was the self‐reported comfort levels and self‐reported practice in LGBT health care. Secondary outcomes included individual comfort toward LGBT colleagues and patients who are LGBT, and the frequency of colleagues making discriminatory statements toward LGBT patients and staff in the emergency department setting. Associations between personal and program demographics and survey responses were also examined.

Results

There were 319 responses The majority of respondents were male (63.4%), Caucasian (69.1%), and heterosexual (92.4%). A sizeable minority of respondents felt histories and physical examinations were more challenging for lesbian, gay, or bisexual patients (24.6%) and more so for transgender patients (42.6%). Most residents do not ask patients to identify sexual orientation when presenting with abdominal or genital complaints (63%). Discriminatory LGBT comments were reported from both fellow residents (16.6%) and faculty (10%). A total of 2.5% of respondents were uncomfortable with other LGBT physicians, and 6% did not agree that LGBT patients deserve the same quality care as others.

Conclusion

A number of residents find caring for LGBT patients more challenging than heterosexual patients. Even with professed comfort with LGBT health care, most residents report taking incomplete sexual histories that may affect patient care. Attitudes toward LGBT patients are mainly, but not completely, positive in this cohort.