UMMC opens primary care clinic for LGBTQ patientsPublished on Thursday, October 10, 2019As a gay man in Mississippi, Wes McComas wants what many people in that community go without: a doctor who understands his medical needs. No judgment regardless of his gender identity or sexual orientation.Primary care for his hypertension and everyday ills delivered in a welcoming environment.“I’ve been out since 1986, but many times, I wouldn’t let my provider know it,” said McComas, a Jackson resident and social worker. “I was afraid it would affect the care I received.”His safe place is the University of Mississippi Medical Center’s TEAM Clinic at the Jackson Medical Mall. TEAM stands for Trustworthy, Evidence-based, Affirming and Multidisciplinary Care. Sponsored by UMMC’s Center for LGBTQ Health, it’s the state’s first multidisciplinary LGBTQ health clinic and one of few in the region.Its mission: to ensure every Mississippian has access to accepting, high-quality and holistic primary health care, no matter their gender identity or sexual orientation.“We want to provide a supportive, welcoming and affirming environment, because there’s often fear about opening up and revealing things about yourself to your doctor,” said Dr. Scott Rodgers, professor and chair of the Department of Psychiatry and Human Behavior. “By being open and welcoming, we can help patients who need to talk and to be honest with their doctor about their sexual orientation or gender identity.”That patient-provider relationship can mean everything to McComas and members of the LGBTQ community. On a recent visit to Jim Miller, a nurse practitioner at the clinic, McComas discussed his weight – the scales showed he’d dropped a few pounds – and strategies for keeping his blood pressure in check.“It’s a little high today,” Miller told McComas after gently chastising him for eating a fast-food lunch that day. “How’s your salt intake? I’d really encourage you to stop eating salt.”“I can do better,” McComas told him. “It’s a process,” Miller reassured him, advising he walk for exercise and ordering bloodwork to gauge his potassium level.The clinic, which sees patients by appointment the first Friday afternoon of the month, also offers wellness visits, endocrine and hormonal treatment, gender affirmative medicine, STD screening and treatment, and behavioral health/psychiatric services and medication management, among others. The care team includes specialists in family and internal medicine, pediatrics, psychology and psychiatry.Rodgers and Dr. Leandro Mena, professor and chair of the Department of Population Health Science in the John D. Bower School of Population Health, are co-founders of the Center for LGBTQ Health, and Mena serves as medical director of the TEAM Clinic. Also on the Center for LGBTQ Health leadership team are Dr. Alexandria Delozier, instructor in psychiatry and human behavior, the center’s director of research and TEAM Clinic associate medical director; and Reid Black, a third-year student in the School of Medicine, the center’s education director.The TEAM Clinic isn’t UMMC’s only care offering for members of the LGBTQ population. The Department of Psychiatry and Human Behavior also staffs an LGBTQ specialty clinic offering mental health services. That clinic, which opened in 2015 at the Jackson Medical Mall, provides psychiatric care as well as psychotherapy.As the specialty clinic gained momentum, Rodgers said, “we were getting questions about primary care issues that we couldn’t handle in psychiatry. We needed a multidisciplinary approach to care.”Rodgers and members of his department began meeting monthly with pediatricians, obstetrics and gynecology faculty, and internal and family medicine providers to discuss care that goes beyond mental health services. Psychiatry faculty did their homework, using a portion of a $40,000 grant from the Women’s Foundation of Mississippi to observe services at institutions including the Fenway Institute’s National LGBT Health Education Center and Boston Children’s Hospital.The institute is an arm of Fenway Health, “the largest hospital in the world that treats the LGBTQ population” in addition to people living with HIV or AIDS, Rodgers said. “We wanted to learn from the best people in the country. From that experience, we began building our clinic.”While the specialty clinic will continue to offer mental health services, the TEAM Clinic gives patients day-to-day medical treatment and help with managing chronic conditions such as diabetes, with referrals to specialists when needed. “We have a group of experts who do this as an interdisciplinary team, and that’s important because this can be a high-risk population,” Delozier said. “There are higher rates of suicide and depression, a lot of that due to discrimination.”A big challenge statewide for LGBTQ patients is finding a provider who understands their medical needs, she said. “They’re doing their best, but they might not have the training on what to offer and what to do next,” she said. “You might have a primary care provider who is sensitive, but if the clinic staff is not, it can be hard to cope with.”Feedback on the clinic so far “has been great,” Delozier said. “Patients feel like they have a safe space. A lot of providers have been really supportive. Some have felt they’re not trained to take care of this population.“Knowing that we are here takes a burden off people’s minds. We’ve had patients who just want to come in to establish care.”“I can ask things that won’t surprise them,” McComas said. “As an older gay man, I feel better knowing that my provider will know the questions to ask me. A couple of my friends have not seen a doctor in a very long time. Especially with the gay bashing, that can be very frightening, but here, I’m perfectly safe.”Ideally, the TEAM Clinic sees patients by referral, but anyone can make an appointment, Rodgers said. The Department of Psychiatry and Human Behavior refers patients to the LGBTQ specialty clinic, which from time to time will refer its patients to the TEAM Clinic.