As a newer member of the team at Mazzoni Center Family and Community Medicine, I’m frequently scheduled to see new patients. In many ways, this provides me with a unique vantage into the populations we serve. I am consistently struck by the high number of patients, especially women, who tell me they haven’t seen a health-care provider in many years, or they have delayed necessary medical care due to inconsistent insurance coverage or negative experiences with the health-care system. Given what I know about the mainstream health-care system, I suppose I shouldn’t be surprised.
Members of the LGBT communities have historically faced and continue to confront significant barriers when it comes to accessing and receiving quality health care. While many people in the United States struggle with the rising cost of health care, and with accessing adequate, affordable insurance coverage, LGBT people also face institutional and social discrimination that often prevents them from accessing care. A 2010 Lambda Legal survey revealed that 46 percent of lesbian, gay or bisexual respondents and 70 percent of transgender and gender-nonconforming respondents had experienced at least one form of discrimination in health, including being denied care, having health-care professionals refuse to serve them and being blamed for their health condition. These experiences lead many LGBT people to put off seeking health care, and contribute to poorer health outcomes in the long run.
That’s why places like Mazzoni Center are so important for the LGBT communities. From our patient registrars at the front desk to the team of care providers to our onsite pharmacy, we are staffed by a team of highly trained professionals who understand the particular needs and concerns of our communities, and are committed to treating each patient with respect and compassion. About one-third of the patients we see don’t have health insurance, but our sliding-scale payment option allows them to receive care just like anyone else.
Our staff includes teams that specialize in HIV/AIDS care and transgender health care for individuals of all ages, which sets us apart from most primary-care facilities. We are also committed to serving the needs of LGBT youth, who are among the most vulnerable in our community — many forced to leave home, struggling to find safe, permanent housing, at high risk of abuse or exploitation. Our Wednesday-night youth drop-in clinic provides a safe space that is designed specifically for young people ages 14-24, and offers everything from primary medical care along with a range of support services, from dental-care referrals to housing and vocational support.
I’m a relative newcomer to Philly, but I’ve been impressed with my experience here. I went to medical school at Albert Einstein College of Medicine in the Bronx and completed a residency in family medicine and a fellowship in family planning at Albert Einstein College of Medicine/Montefiore Medical Center. After I completed my clinical training, I did a reproductive health-advocacy fellowship with Physicians for Reproductive Health. When I learned about the opportunity to work at Mazzoni Center, I knew it was the right place for me, as it would allow me to combine my interest in family medicine and women’s health with the ability to work in more specialized areas like trans health and adolescent care.
You hear a lot these days about how fewer medical students are choosing primary care or family medicine as their specialty. In my case, it felt like an ideal path. It allows me to treat all kinds of people at all ages of their life: kids, adults, pregnant people. I’m able to get to know people both when they’re well and when they’re sick, which gives me a valuable perspective.
I like that I’m able to provide care for families and couples, become familiar with the people important in a patient’s life, and that I’m trained to assess the impact of social and environmental influences on health, which I feel is extremely important.
Community-based centers like Mazzoni are particularly rewarding places to work because the clinic feels like a community and a safe place. Everyone who works at the clinic gets to know the patients and can help facilitate the best care possible. Our team of providers works closely and collaboratively. I believe all of these things make a difference in the long-term health and well-being of the people we care for.
It’s been a year since I arrived, and my experiences at Mazzoni have made it even more clear how much the health-care system needs to change in order to provide better care for LGBT people. But I’m grateful to have found a place where I can practice the kind of medicine that I believe is critically important, contribute to the training and education of future health-care providers, and work with populations I feel passionate about serving.
It all starts with primary care, and establishing a relationship with a provider that you trust. If you’re one of those people I mentioned above, who has had a negative experience with health care in the past, or simply hasn’t been to see a doctor in a while, think about changing that today. Your health is worth it.
Lin-Fan Wang, MD, is a doctor at Mazzoni Center Family and Community Medicine.