Member Spotlight | Continued from page 17 mind about what having a primary care provider can be. For example, I think some men who have sex with men have felt that all of the other care providers they’ve seen don’t really take the time to understand the gay culture or gay sex. I’m really proud I can be a resource for these folks and create a space where they can feel comfortable talking about things with me that maybe they’ve never discussed with another provider. It seems to me that all people should be able to feel comfortable with their PCP – like there will be no judgment about how someone is living their lives. If they have a question about this or that, their provider will be knowledgeable about it and able to provide information that is evidence-based and culturally informed. I’m glad that my knowledge is broad, and that I feel equally comfortable talking about SSRIs and anal sex and reliable forms of contraception. It makes me feel like a reliable medical information resource to my community. But I also wish that someone like me didn’t need to exist. By that, I mean I wish that there didn’t need to be a primary care provider who knows a lot about LGBTQ medicine because really, what that is saying to other primary care providers is that this is “specialty medicine,” and it takes the onus off of them to know how to care for this population. I don’t believe that should be allowed or tolerated. As primary care providers, we don’t have a choice about who we get to see — that is not the spirit of primary care. We know a little bit about everything. I don’t think it ’s okay for a gay man to go to a doctor in Provo or Vernal asking to be put on PrEP, and the provider says, “That ’s not something I do; you’re going to need to see someone else.” Because it should be something they do. It must be. Gender affirming hormone therapy and HIV Prevention aren’t specialty medicines, they are primary care. Medical schools across the country need to do a better job of incorporating LGBTQ medicine into their curricula. There is so much legislation targeting the LGBTQ community seemingly sweeping the nation. It is obviously hateful and intended to further disenfranchise and cause deliberate harm to an already marginalized community. It is medically uninformed, and when viewed through the “arc of the moral universe,” it will in time be recognized for what it truly is: hate speech manifested as legislation passed by bigoted and ignorant zealots. I am embarrassed by any legislature that enacts laws deliberately seeking to further marginalize the LGBTQ community and remain cautiously optimistic that these laws will be repealed or overruled as unconstitutional, which they most certainly are. Practice Changes Due to COVID-19 I have an entire day that is now virtual visits solely due to the pandemic. I think this is great and that a lot of medical problems really lend themselves to the virtual format. I hope virtual visits don’t go away and reimbursement rates don’t decrease for virtual visits because I think we would stop offering them. I am convinced that virtual visits have expanded the capacity for individuals to receive care they otherwise would not have received. This is particularly true for marginalized communities like LGBTQ folks, especially those living in rural communities. But I worry that reimbursement rates for these visits will drop, and we would be economically forced to stop offering them. That would be calamitous to these vulnerable populations, particularly in the conservative intermountain west. Right now, we are experiencing massive staffing shortages, and I think this means that we need to pay our support staff more money to encourage folks to enter healthcare. Similarly, we need to improve reimbursement rates for primary care to keep primary care providers in the workforce. If we don’t do something about pay inequity in the primary care space, we will not have the clinical bandwidth to care for our population. Every family physician in our practice works part-time (clinical) because the reality of seeing 25 patients a day, four and a half days a week, just isn’t sustainable long-term. Simply put, family physicians need to be paid more. By improving reimbursement rates for primary care, family physicians would not be forced to see 25 patients a day — the pace just isn’t sustainable. I am convinced that virtual visits have expanded the capacity for individuals to receive care they otherwise would not have received. This is particularly true for marginalized communities like LGBTQ folks, especially those living in rural communities. UtahAFP.org | 18
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