Finding the perfect doctor: Identifying LGBT-competent healthcare providers

Background: Lesbian, Gay, Bisexual and Transgender (LGBT) individuals face significant barriers to receiving equitable health care. Our objectives were to determine whether and what systems are in place at academic medical centers to identify LGBT-competent primary care providers and if LGBT-competency training exists. Methods: We conducted a systematic survey of 138 LCME-accredited U.S. medical schools, and 51% participated. We assessed the existence of policies to identify LGBT-competent providers and LGBT-competency training, and their association with institutional characteristics including region, public vs. private school, and the presence of an LGBT Center of Excellence (CoE) in the same state. We performed univariate and bivariate analyses, and constructed a logistic regression model. Results: Ninety-one percent of institutions do not have a procedure in place to identify LGBT-competent providers and only 16% have comprehensive LGBT-competency training. Nevertheless, 80% of the participating institutions indicated an interest to do more to address these issues. Private schools were significantly more likely to have policies in place when compared to public schools; additionally, medical schools with an LGBT CoE in the same state were significantly more likely to have LGBT-competency training. Conclusions: This is the first study to identify the existence and systematically categorize the policies and programs that U.S. medical institutions have in place to train and identify LGBT-competent providers. The vast majority of academic medical centers do not have policies or programs in place to address these issues. The lack of training and identification of LGBT-competent providers may be contributing to inequitable access.