Inclusive Care in Medicine

I attended a conference on perinatal mental health earlier this year and though the range of topics discussed and presented was broad, there was a common thread weaved throughout virtually every presentation: inclusivity. Inclusivity there at the conference, in our practices, in simply how we live our lives. It was discussed by people of colour, providers who identify as queer, and most predominantly by a transgender man who was presenting on his experience of being pregnant and giving birth. I learned so much at that conference about mental health and how we can better support and serve our patients/clients (referred to as “clients” from here) but one of the big takeaways for me was the result of me really looking at myself and the way I practice.

I hadn’t really thought much about providing inclusive care but my first thought about it was that yes, of course I provided inclusive care. I am open to caring for any individual, and I don’t discriminate which clients I take based on their background, their relationship status, or their sexual orientation. I thought that was enough and it turns out that I was wrong. Truly providing inclusive care is so much more than passively tolerating people with different backgrounds and potentially different needs; it’s an active, constantly evolving way of practicing that results in every individual having care that is tailored to them in a way that is safe, supportive, and will ultimately result in better outcomes.

Inclusive care is certainly an important issue in maternity care as we see that people who belong to marginalized communities have poorer outcomes but it is important in all aspects of medicine. In talking to and learning about practices who have made providing inclusive care a priority, I’ve identified some ways I plan to incorporate inclusivity in the care I provide people both as a naturopathic physician and as a midwife and I will share the five simple changes you can make to your practice to provide better care to your clients:

  1. Education Yourself - The first step to becoming a more inclusive provider is to simply educate yourself. Maybe you don’t even know what inclusivity means and that’s ok; we all start somewhere. Figure out why this is important, look at the data, talk to other providers about what they are doing. There is room for all of us to do better.
  2. Go Public - This is a big one: be public about your intentions to provide inclusive care. Write about it on your website/Facebook page etc. Tell your patients/clients that it is your intention to change your language and your care to better serve the population as a whole, not just the cis, straight, white male population. Tell them about how that is going to look and what it means for their care. Forms might look different, language will be different, and your client population will be more diverse.
  3. Go Up - It’s not enough to just change your individual practice. You need to think bigger. Change your forms to use inclusive language. Do you use government forms? What are they doing to make their forms more inclusive? Their published material (leaflets, flyers etc.)? Every time you fill out a standardized form think about how it could be improved and work on it. This will be challenging, but with enough people demanding change it will eventually happen.
  4. Talk to Your Client  - Ask your patients how they want to be referred to (she/he/their) and discuss their individual needs as a client. They will usually have an idea about what they need and will appreciate your honesty and openness. Even simply saying, “I don’t know” can be so powerful.
  5. Re-Assess - Make a few changes and then plan to re-visit these changes every six months or every year. Come together as a practice/team and discuss what works and what doesn’t work. Include it on your standing agenda for your meetings. Go back to number one and continue your education.

All of us health care providers prioritize patient safety and quality of care. I have yet to meet a single health care provider that has anything else at the top of their list other than providing the best care to result in the best outcome for the people they are looking after. Inclusive care is just one other way that you can improve outcomes and the overall quality of the care you are offering to people. People who feel marginalized by the health care system will be less likely to access care when they need it so the onus is on us to make health care safe for everyone and to publicly identify ourselves as a safe place for them to go. We can all do better.

Happy Pride, Fernie!