Primary care, prevention, and coordination of care

In this chapter, we describe how primary care providers (PCPs) play a crucial role in delivering high quality, cost-effective, patient-centered care for lesbian, gay, bisexual, and transgender (LGBT) patients. We discuss the importance of PCPs recognizing patient autonomy in self-identification as the basis for an open and trusting patient-provider relationship. We emphasize how that relationship promotes whole-person care and describe how PCPs can utilize effective verbal and written communication that reflect sensitivity to LGBT patients. We describe evidence-based health promotion and preventive health recommendations for LGBT patients, including physical, mental, and emotional health considerations, immunizations, and screening tests. We explain the need for PCPs to critically evaluate and apply current and emerging medical information to optimize care for LGBT patients. We emphasize that PCPs must be aware of the emotional and mental health impacts of societal stigma, recognize that many LGBT patients define family broadly, and advocate for quality care. We provide several advocacy strategies such as identifying consultants who are knowledgeable about and sensitive to LGBT patient care needs, as well as coordinating patient care within the health system by collaborating with LGBT community resources.