When Sebastian Trabucco moved from Rhode Island to start his job as marketing outreach coordinator for Hartford HealthCare Senior Services, he needed a new primary care doctor. As a gay man, it was important to him to find a physician who was well versed in caring for the LGBTQ+ community.
When HHC Program Management Director Mona Heredia was looking for a doctor for her Peruvian mother-in-law, who was living with Alzheimer’s and other health issues, the family wanted a provider who is fluent in Spanish and also understands her Latin American culture.
It wasn’t easy for either of these colleagues to find the doctor they were seeking, even though they work at a large healthcare system. No clearinghouse of providers knowledgeable in LGBTQ+ care or who spoke Spanish existed.
That’s about to change.
Provider directories
Hartford HealthCare’s Colleague Resource Groups representing LGBTQ+ and Hispanic/Latinx colleagues have worked for more than a year to create provider directories specifically addressing the needs of their communities. The LGBTQ+ directory will include providers specializing in gender-affirming care as well as sexual and reproductive health needs.
The Hispanic/Latinx provider and allies membership guide, which will be for internal use among Hartford HealthCare providers, will include Spanish-speaking doctors and anyone well-versed in Hispanic/Latinx cultural norms. There is already a public-facing directory on the HHC Spanish-language website for patients.
“So often individuals in marginalized communities are hesitant to reach out to providers for fear of being stigmatized or having to educate the provider,” says psychologist Laura M.I. Saunders, PsyD, director of HHC’s Center for Gender Health. “Having a directory that highlights specialized areas of competency in working with an underrepresented community will go a long way to improving access to quality care.”
It’s more than language
Heredia recalls looking for a residential facility for her mother-in-law and wanting to make sure staff were comfortable with a large Latin American family coming to visit, often all at once. She also wanted her mother-in-law to be comfortable.
“It is so important for patients to feel loved and taken care of in a way they understand,” Heredia says. “Healthcare providers need to be aware of cultural and language differences. You have to have confidence in the person taking care of you.”
Jennifer M. Doran,senior director of practice strategy and operations for Hartford HealthCare Medical Group and member of the Hispanic/Latinx CRG, notes, “Healthcare can be complex and difficult to navigate. The added difficulties of language and cultural barriers makes it even more of a priority for our system to be sure all our Hispanic/Latinx providers and allies are aware of each other.”
The directory, she adds, will provide “patients with access to doctors, providers and clinicians who can provide culturally competent care. Having a provider directory that is for providers themselves allows for the community to be supported and for connections to be made.”
For the LGBTQ+ community, Trabucco adds it’s not just listing providers with the necessary skills, which ranges from understanding and preventing/treating HIV/AIDS to offering medical, surgical, mental health and support services for transgender and nonbinary people.
The LGBTQ+ CRG plans to offer webinars and programs several times a year for “those who want to be allies so they understand the terms, practices and beliefs within the community (and) it’s not just providers with lived experience. In a perfect sense, all our providers would be gender-affirming allies, he says.
It’s not just a list
In October 2020, the Chase Family Movement Disorders Center opened a Spanish-language center in the Brownstone Building in Hartford with neurologist Maria L. Moro-de-Casillas, MD. The Brownstone has provided community primary and specialty health services in the city since 1969. Dr. Moro-de-Casillas led the initiative because she has witnessed the health inequities faced by the Hispanic/Latinx community.
Realizing that duplicating a physical space like that across the system was impossible, the Hispanic/Latinx CRG began talking about creating a similar network, says José M. García, Digestive Health Institute regional director for Hartford and Northwest regions. At the time, he and Doran co-chaired the CRG.
“How could we take that concept and scale it across the system?” Garcia asks. “By building a provider and ally network to improve the health and outcomes of the Hispanic/Latinx community.” A workgroup conducted a listening tour, talking with providers about what they saw and how to overcome language and cultural barriers.
Providers “are so excited” to be asked to participate, Garcia says. “We asked them, ‘What are the opportunities?’ ‘What can we help accomplish?’ ”
Garcia says the group researched networks at other healthcare systems in the U.S..
“We can’t find anything like this elsewhere,” he says. “Our goal is to truly improve the outcomes for this population, to be the gold standard. It is an ambitious goal. We are building it from scratch but we feel this is the right thing for our patients.”