Harvey Makadon, M.D. (center), pictured with UAB faculty members Nicholas Van Wagoner, M.D. (left) and Michael Saag, M.D.Harvey Makadon, M.D., has a clear message for healthcare professionals: we must begin to recognize that significant health disparities exist among the LGBT community and develop a more culturally competent approach to delivering care to this at-risk population.In his talk, “Achieving Health Equity for Lesbian, Gay, Bisexual and Transgender People,” delivered at Medical Grand Rounds on Wednesday, March 11, 2015, Makadon presented compelling statistics in support of his case, including greater risk of suicide among LGBT youth, higher incidence of sexually transmitted infections among men having sex with men, and LGBT populations having the highest rates of tobacco, alcohol, and other drug use.
“Most of the [LGBT health] disparities that we know about are really the result of stigma and discrimination. Implicit and explicit bias on the part of health professionals unfortunately is a large part of that,” Makadon said.
As the director of the National LGBT Health Education Center of the Fenway Institute, Makadon encourages health professionals to re-examine their understanding of sexual orientation and gender identity (SOGI), and to more fully engage their patients in effective dialogue in clinical settings. He noted that the Centers for Disease Control and Prevention developed a simple categorization of sexual history questions that may help providers focus on key issues and incorporate gender-neutral language. Makadon also strongly urges the health care community to focus on the collection of SOGI data for the electronic health record.
“We are not going to be able to [address inequity] if we don’t learn deal with the communication issue. We have to figure out how to ask questions in a reasonable way and track it in the health record so we can take the next step of incorporating this type of training into our formal medical education,” he said.