Many cite their religious beliefs and say they influence patient care
About one-fifth of clinicians responding to an international survey said felt unprepared to treat gay patients and some indicated that their own religious beliefs about homosexuality affect the care they give.
Results from the survey of more than 10,000 physicians, nurses, medical and nursing students, medical technicians, and pharmacists in some 40 countries were reported here at CHEST 2017, the annual meeting of the American College of Chest Physicians.
When asked the question, “Do your beliefs about homosexuality affect the care you provide to a patient that is homosexual?” 10.3% of clinicians identifying as non-Christian responded that it did. More than 22% of Jehovah’s Witness clinicians and 16.7% of Hindus responded affirmatively to the question.
Just over 20% of non-Christian/non-Catholic providers and 16.6% of Christian/Catholic providers reported that they did not feel prepared to provide care to homosexual patients.
“The beauty of this study was that it was anonymous, so people told you what they actually thought,” study author Joseph Varon, MD, of Texas Medical Center, Houston, told MedPage Today. The survey results presented at the meeting included information about the religion of the responding clinicians, but not their country or region.
Study co-author Rachel M. Riley, MD, of Texas Medical Center, said the observation that certain patients were treated differently at the center led to the survey.
“Certain ethical questions came up, and we wanted to know if they were unique to our center,” she said.
Mark J. Rosen, MD, of the Mount Sinai West Respiratory Institute, New York City, told MedPage Today that he does not believe the findings are reflective of attitudes in the U.S. He was not involved with the research.
“My conjecture would be that this is no longer a big issue among the vast majority of healthcare providers in the United States, or Canada or most of Europe,” he said. “We certainly did see it at the height of the AIDS epidemic, but three decades later, attitudes have changed a lot.”
Rosen added that clinician prejudice does routinely influence patient care in the United States. But he said these prejudices tend to be focused on patient behaviors that lead to poor health and disease, such as obesity, smoking, and substance abuse.
The researchers plan to do a subanalysis of the survey data to address the regional question.
But Varon said he has little doubt that prejudice continues to play a role in patient care in the United States.
“I saw it throughout my training, and throughout my career,” he said. “For example, if a clinician knows a patient is homosexual, that patient may automatically get an HIV test. Patient permission is required in Texas to do an HIV test, but a lot of doctors don’t even ask.”
The anonymous 30-question survey was distributed from July 2015 through February 2016 to clinicians in 174 different institutions.
Of around 30,000 surveys sent, a total of 10,106 were completed, including 53% (n=5,354) among physicians and nurses, 33.2% (n=3,351) among medical and nursing students, and 13.1% (n=1,328) among other healthcare providers (respiratory technicians, pharmacist, caregivers, etc.).
The most widely represented religion among these providers was Catholic/Christian 70.5% (n=7,122), followed by non-Catholic/Christian 27.3% (n=2,762), Islam 6% (n=611), Hinduism 4.4% (n=448), Protestant 3% (n=308), Jewish 1.4% (n=137), Jehovah’s Witness 1.3% (n=134), Buddhist 1.3% (n=128), Mormon 0.8% (n=83) and others 9% (n=913).
“At the end of the day, the most important thing we found was that one out of every five health care providers out there either don’t feel comfortable caring for homosexual patients or treat them differently,” Varon said.
“In this day and age, this is not acceptable.”