Heathcare workplace disclosure of LGBT identity: Survey of Physician Asssistants

Background: Lesbian, gay, bisexual and transgender (LGBT) health care providers have historically faced discrimination despite inclusive policy statements by professional organizations such as the American Medical Association. To date, LGBT discrimination studies have been conducted with physicians and nurses. This is the first study assessing the workplace environments of physician assistants (PAs) regarding disclosure of LGBT status. The purpose is to describe workplace culture and attitudes, and to evaluate awareness of workplace and professional policies regarding LGBT discrimination. Methods: A survey was sent to 175 PAs across the U.S. Chi-square tests, Odds Ratio, and Fisher Exact Test were used for statistical analysis. Results: The response rate was 33%; 58 surveys were included in the study. Respondents were primarily female, 30-39 years old and worked in suburban, outpatient settings. Physician assistants had an overwhelmingly positive attitude towards LGBT providers. The majority of respondents were not aware of relevant policy statements from professional organizations nor at the institutions they worked. A significant association existed between policy awareness and LGBT inclusivity (p<0.025) and confidence reporting anti-gay harassment (P = 0.017). Predictors of LGBT inclusivity at work included age (p<0.05) and specialty (P = 0.039). Respondents were split in their estimation of whether a practice would experience patient loss after provider disclosure of an LGBT identity. Implications: Despite improved attitudes, discrimination still exists and is linked to policy standards and awareness. In addition to policy change, improved work conditions and, ultimately, patient care may require visible support of LGBT providers from top management.