MUSC broadens approach to LGBTQ inclusion

A growing body of research is showing that members of the LGBTQ community tend to have worse health outcomes. As part of its mission to reduce health disparities in South Carolina, the Medical University of South Carolina is increasing its focus on providing culturally competent care to this community as well as looking inward, as an employer, at how to ensure that all staff feel comfortable. 

Chase Glenn, who was hired last spring as MUSC’s first director of LGBTQ+ Health Services and Enterprise Resources, is a big part of this updated focus, but he’ll be the first to say that many others on campus are passionate about this issue and are leading efforts in their areas.

An example was the Culturally Sensitive Care Workshop held in October. Now in its fourth year, the 2021 edition focused on LGBTQ issues.

Co-chair Cristina Reyes Smith, OTD, an assistant professor in the College of Health Professions, noted that during last year’s workshop, which was focused on mental health issues, the panel devoted to LGBTQ mental health issues generated such interest and enthusiasm that she observed at the time that there needed to be an entire workshop dedicated to LGBTQ issues.

That came to be this year. Co-chair Latecia Abraham-Hilaire, DHA, Academic Affairs associate professor with the public information and community outreach department with the MUSC Libraries, said it was wonderful to see the mix of students, faculty, community members and even some representatives from other local colleges at the workshop, which this year was held in a hybrid in-person/virtual format.

 

Abraham-Hilaire moderated a panel of local advocates, and other panels focused on transgender needs, an inclusive workforce and curricular gaps and included a keynote address by Jack Turban, M.D., chief fellow in child and adolescent psychiatry at Stanford University School of Medicine.

“I think, if anything, the takeaway is that the LGBTQIA+ community definitely needs to remain hopeful,” Abraham-Hilaire said. “We definitely wanted to provide hope for this community and to let them know that they’re not standing alone in this fight for equality.”

Reyes Smith said she’s noted for some time an educational gap related to LGBTQ issues, not just at MUSC but nationally.

“Personally, I have friends and loved ones that identify with the community, and so being able to help provide a more inclusive campus and a more inclusive community is important to me as well,” she said.

She said that being an inclusive campus goes beyond caring for LGBTQ patients. There are students and faculty members who are part of the community as well, and it can be tricky for them to know whether it’s safe to be out with colleagues or patients. In fact, a small survey of participants at the workshop indicated that a number of them weren’t out in their academic programs or work environments.

“We still have a lot of work to do,” Reyes Smith said.

Both Abraham-Hilaire and Reyes Smith said the workshop really drove home the importance of using a person’s personal pronouns.

Glenn said that pronouns are one example of how providers can either build or break trust with LGBTQ patients, even if they’ve come in for an issue unrelated to sexuality or gender – a broken leg, for example.

“If it's a broken leg and you misgender someone, and you call them by the name that they very clearly don't use, you’re starting off – well, you're starting off on the wrong foot,” he said. “And then, right out of the gate, you’re having to repair that sort of interaction and recover. So some of this is just really basic respect and compassion when it comes to how we're interacting with patients.”

In his six months at MUSC, Glenn has been getting to know what’s already in place across the statewide MUSC system as well as working on some long-term goals that date back to when he was executive director of the Alliance for Full Acceptance. Those include getting MUSC Health back onto the Human Rights Campaign’s Healthcare Equality Index and including data about sexual orientation and gender in Epic, MUSC Health’s electronic medical record system.

“I think the takeaway here is we want to be really thoughtful in how we implement these changes, and we want to prepare our care team members to feel comfortable and to be able to have positive interactions with patients,” Glenn said. “Because at the end of the day, we can capture the information, but we could do it in a way that is not a positive experience for either the care team member or the patient, right? So we want to make sure we set this up for success.”

“Leadership has been clear that participating in the Healthcare Equality Index is not necessarily about a certification. It's not about being able to put a badge on our website. It's really about taking us on this journey to improving the care and our work with LGBTQ folks."

Chase Glenn

Glenn has also submitted an application for MUSC Health’s inclusion on the Healthcare Equality Index. The index, which grades facilities based on an array of policies and procedures related to patients, employees, visitors and community engagement, offers a road map for some areas that MUSC could still work on, Glenn said. Overall, though, he is pleased with how seriously hospital leaders view this issue. 

“Leadership has been clear that participating in the Healthcare Equality Index is not necessarily about a certification. It's not about being able to put a badge on our website. It's really about taking us on this journey to improving the care and our work with LGBTQ folks,” Glenn said.

Glenn is also waiting on a report from The Fenway Institute’s National LGBTQIA+ Health Education Center, which will be developing cultural competency training customized to MUSC’s needs, with the ultimate goal of LGBTQ patients feeling comfortable interacting with anyone on campus, rather than being directed to specific providers who are known to be LGBTQ-friendly.

The physician assistant program in the College of Health Professions has been working on this so that all of its graduates will have training working with people from a variety of backgrounds, said Emily Douglas, PA, an instructor in the Division of Physician Assistant Studies.

This year, she said, the PA program began teaching students in the History and Physical Exam Skills course to ask about pronouns and to use gender-neutral language. The PA program is also developing a mandatory cultural competency course, which will include lessons on LGBTQ issues.

Douglas required all of her students to attend the Culturally Sensitive Care Workshop and to write up a reflection afterward. Many of the students commented that they had never thought about the necessity of creating a safe space within a clinical environment or how to do so, she said.

“That was something a lot of students really talked about, never thinking about before, but something that they're going to incorporate into their future practice,” she said. “So that was really, really wonderful to see them have that ‘aha!’ moment.”

Hopefully, that “aha!” moment will be replicated across the state this spring, Glenn said. The Department of Diversity, Equity and Inclusion is planning a virtual LGBTQ health care conference for April 7-8 targeting health care providers and students throughout South Carolina.

More information about the conference will be posted on the DEI website in the coming months. Glenn said he believes that there’s an eagerness on the part of students and providers from all organizations to take part in this type of educational opportunity.

“LGBTQ identity is an important part of someone's health profile and knowing this information can in fact impact the care that they receive,” Glenn said. “If we really are committed to providing the highest quality of care and meeting patients where they are, then this is an important part of that process.”