Transgender Is Not a Verb: Three Ways to Provide Compassionate Care to Trans Patients

By Stephanie Aldrin, Medical Student

According to the Institute of Medicine, transgender and gender nonconforming patients access health care less often than their cisgender counterparts. And when transgender patients do seek medical attention, it is often with more serious ailments.1 While many factors contribute to these disparities, health care providers can play a crucial role in reducing the stigma associated with seeing the doctor and in promoting safer health care environments for the trans members of our communities.

In fall 2015, the clinic I work at, Smiley’s Family Medicine Clinic, asked its patients who identify as transgender or gender nonconforming to speak candidly about their experiences accessing primary care. I remember scrambling to take notes as I listened to the patients’ stories and feeling grateful for the opportunity to have this small window into the challenges of seeking health care as a trans person.

Three major themes emerged from the patients’ experiences. First, small changes in language can positively impact the way a patient feels during and after an encounter with health care providers. Second, trans patients see their doctors for a number of reasons, and, like their cisgender counterparts, want to be seen as any other patient and not have their gender identity be the focus of the visit. Finally, positive partnerships occur when physicians come into the exam room as their authentic selves, who genuinely care about the patient in front of them.

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What If Prince Had a Waivered Family Physician?

By Matthew Martin, PhD and the members of the STFM Group on Addictions

A Prince in Crisis

On April 21, at 9:43 am, the Carver County Sheriff’s Office received a 911 call requesting that paramedics be sent to Paisley Park. The caller initially told the dispatcher that an unidentified person at the home was unconscious, then moments later said he was dead, and finally identified the person as Prince. The caller was Andrew Kornfeld, the son of Howard Kornfeld, MD, an addiction medicine specialist from Mill Valley, CA. Andrew, a pre-med student, had flown to Minneapolis with buprenorphine that morning to devise a treatment plan for opioid addiction. Emergency responders tried to revive the musician but later pronounced him dead at 10:07 am.

On April 20, the day before, Prince’s representatives contacted Dr Kornfeld, who agreed to see Prince later that week. Dr Michael Schulenberg, a family physician in Minneapolis, saw Prince on April 7 and April 20 apparently for opioid withdrawal. However, Dr Schulenberg is not a waivered physician and thus could not prescribe buprenorphine. If he had, perhaps Prince would now be recovering in a comfortable treatment center in California receiving state-of-the-art medical care. He would likely be receiving buprenorphine treatment to prevent opioid withdrawals. Recent autopsy results show that Prince died from an accidental overdose of Fentanyl.

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“Dear Esteemed Author:” Spotting a Predatory Publisher in 10 Easy Steps

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Christopher Morley, PhD

If you read the title and had some idea what it meant, you have probably received a letter from a dubious-looking publisher, asking you to submit your work. Often, it comes with an appeal to your ego and probably left you with a sense of wondering if this was a real solicitation.

In short, that solicitation was probably not “real.” What does that mean? To use current parlance, it means that such an invitation probably came from a “predatory publisher.” Predatory publishers1-3 are called as much because they:

  • Charge the author to publish in their usually online-only journal.
  • Connect that charge to the publication decision (this is key).
  • Do only a cursory review, if any at all (and many can be easily “pranked” into accepting garbage)
  • Appear to be “legitimate” superficially but will often not pass muster with promotion and tenure committees, agencies or accrediting bodies, or other interested parties.

It should be noted that not all “author-pays” models are illegitimate or predatory, and I will comment on that point further down. However, those that are will leave your paper “published” in a non-reputable journal that will not get you or your department/program the credit it needs. It also cuts off other publishing options and may leave you with a very expensive bill that may or may not have been fully disclosed at the outset. At the end, predatory journals are generally viewed as “vanity presses,” with the added problem that they take efforts to look legitimate from an academic standpoint, and authors do not realize they have submitted their work to a vanity press until it is too late.

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