Nondiscrimination in healthcare
Editor’s note: Guest columnist Kristina Anderson is an associate marketing project manager for HR Solutions, Inc. (www.hrsolutionsinc.com), an international human capital management consulting firm.
Think back to the last time you sought medical care. You went to a healthcare facility trusting that you would be cared for and made to feel safe. However, what if, upon arrival, the forms that you were asked to fill out made you feel discriminated against? What if you were spoken to using harsh or inappropriate language? What if doctors or nurses refused to touch you or even treat you? What if you were admitted and members of your family were not allowed visitation rights?
These are situations that members of the lesbian, gay, bisexual, transgender, and transsexual (LGBT) community face on a regular basis in healthcare facilities across the United States.
The Institute for Diversity’s benchmarking study
New data from a study from the Institute for Diversity in Health Management conducted by HR Solutions show that only 54% of responding healthcare organizations in the United States currently have LGBT-friendly nondiscrimination policies in place. These policies are much more prevalent in some areas of the country than others.
Whereas 100% of participating hospitals in the West reported having these policies in place, the Midwest and Middle Atlantic only reported around 50% of hospitals as having nondiscrimination policies, and only 36% of hospitals in the South reported utilizing these types of policies. The difference by region can be partially attributed to each area’s dominant political and religious beliefs. Healthcare organizations in more conservative areas of the country may face increased opposition to LGBT-friendly policies from their employees and communities.
A total of 182 organizations participated in the 2008–2009 study. They were divided into six regions: Middle Atlantic, Midwest, New England, South, Southwest, and West. The goal of the study was fourfold: to establish diversity benchmarks, measure future progress, educate organizations regarding diversity and disparities, and recognize organizations embracing diversity and leading the way in addressing patient care disparities.
Recently, the focus of nondiscrimination policies has been on visitation rights and advance directives for LGBT patients. Visitation policies in healthcare organizations have traditionally granted visitation rights only to immediate family members. However, LGBT-friendly policies can allow for broader definitions of families, including partnerships, civil unions, and children with parents of the same sex. Nondiscrimination policies should also include a section requiring that organizations uphold advance directives set in place by patients. Advance directives are utilized when a patient becomes incapacitated, allowing for the patient’s wishes to be followed.
There are several other focus points that nondiscrimination policies should cover in addition to visitation rights. For example, although many existing LGBT policies cover nondiscrimination based on sexual orientation, most lack a section about gender identity. This lapse can allow for discrimination against transgender or transsexual patients. In fact, a study from Lambda Legal titled When Health Care Isn’t Caring found that 70% of transgender or transsexual respondents had been discriminated against while seeking medical care.
Organizations also need to make sure that the policies and practices they have in place do not unintentionally discriminate against LGBT patients. For example, hospital forms that ask a patient to check single, married, or divorced may be confusing or off-putting to LGBT patients as they may not identify with any of the categories.
To ensure that patients are not being discriminated against by staff members, organizations should require cultural competency training as part of their LGBT-friendly policies. This kind of training makes employees aware of the organization’s current policies and teaches them to be sensitive to patients’ needs and perspectives. Training will ensure that staff members understand the importance of putting their personal beliefs aside and instead following the organization’s inclusivity policies when treating patients.
Benefits of LGBT-friendly policies
Patients are the ultimate beneficiaries of nondiscrimination policies. Amy Wilson-Stronks, senior director of cultural services for CulturaLink and former project director for healthcare disparities for The Joint Commission, believes that these policies all boil down to an increase in quality and safety for patients. “ Patients need to feel that they can trust their healthcare provider; otherwise, they may withhold important information about their health and condition,” said Wilson-Stronks. This can cause misdiagnosis, which can have detrimental effects on a patient’s health.
Organizations that adopt nondiscrimination policies will also create an environment that is respectful and inclusive of all patients. Ultimately, this will decrease the obstacles that LGBT individuals face while seeking medical care and help enhance the overall patient experience.
The future of nondiscrimination in healthcare
Due to some of the recent changes in the world of healthcare, nondiscrimination policies are about to become much more prevalent across the country. In April 2010, President Obama released a memorandum requiring all hospitals that utilize the Medicare or Medicaid programs to allow visitation rights and respect advance directives for LGBT patients. In addition, The Joint Commission recently announced that nondiscrimination standards will become a part of its accreditation process. These measures are both scheduled to take effect in 2011.
These changes are a huge step in the right direction for the LGBT community. “Really, the purpose of nondiscrimination policies is to promote health equity and allow organizations to provide the highest level of care to every patient,” said Wilson-Stronks. By giving LGBT patients the same rights as every other patient, organizations will ensure that every person who walks through their doors has the best possible patient experience.