When CAFP members Kathleen Kearns, MD, director of Valley Family Medicine Residency of Modesto (VFMRM), Anika Godhwani, DO, Associate Program Director, and resident Andrea Silva, MD, shared mutual concerns about the LGBTQ+ community's healthcare disparities, together they wanted to address the issues. They soon garnered support from other residents and clinic leadership. They all agreed that they felt passionate about taking care of disadvantaged populations. After months of planning, they established The Rainbow Clinic, which opened in November of 2019 at the Paradise Medical Office.
According to Dr. Kearns, The LGBTQ+ community experiences higher rates of discrimination, homelessness, and poverty and is heavily affected by suicidal idealization, depression, anxiety, and high substance abuse rates. The LGBTQ+ and LGBTQ+ adolescent community of Stanislaus County has minimal outreach programs for its size population, and there is a real need for it. The clinic's mission was to give the LGBTQ community a safe space to feel welcome and free of judgment. They knew it was essential due to the number of people seeking these services outside of Modesto, traveling to Stockton, San Francisco, and other areas outside of Modesto.
"LGBTQ+ outreach is one of those types of healthcare that is so rewarding because the patients are especially grateful for the safe space," said Dr. Kearns. "The amount of courage it takes them to walk through the door and to be able to see their appreciation when treated with respect, it is a beautiful thing to be involved with."
One of the team's goals was to get training for all the residents. Residents could then gain experience in taking care of patients in the LGBTQ+ community and bring that experience to wherever their careers may take them. VFMRM began using the University of California San Francisco's curriculum to teach residents the use of pronouns and learn the latest diagnosis terms. With health care being a two-way street between physician and patient, Dr. Silva knew she had to get LGBTQ+ patients to feel comfortable and open up to have a great patient-doctor relationship.
Another goal was to change the narrative in a conservative community. Dr. Silva, Godhwani, and Dr. Kearns collaborated with the LGBTQ+ Collaborative of Stanislaus County in planning the launch of the clinic and planned to attend community outreach events before COVID-19 began. Because in-person outreach and events were no longer an option, the new clinic's marketing strategy had to rely on word-of-mouth and online engagement.
While there was great willingness to contribute, there was also some fear by resident doctors of not getting things right. After incorporating the curriculum and training, residents' fears subsided, enthusiasm grew, and residents found themselves asking patients relevant questions, such as their preferred pronouns.
"I have never felt like I have saved more lives than I have now, especially amongst adolescents. I can meet patients' needs, give them a safe space, and help them get the proper medication for gender-affirming hormone therapy, and it is enriching," said Dr. Silva.
The Rainbow Clinic is open every other Friday, from 1-5 pm at the VFMRM clinic. All residents rotate through and assist in the clinic, giving them each a chance to put their training into practice.
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