Fourth-year medical student Mitchell Moe presented his research project, “Primary Care Access for LGBTQ Patients in Rural Minnesota,” at the 2020 Minnesota Academy of Family Physicians (MAFP) Research and Innovation Forum. Recently, his findings were also published in the MAFP magazine. The study explored the quality of care for LGBTQ patients with an emphasis on awareness and inclusivity, not only between patients and providers, but within the entire clinic. He was inspired by his experience growing up in rural Minnesota as a closeted member of the LGBTQ community.

“Having heard from extended family members and community members in my hometown that being gay was a sin and a mental illness, I felt that the only person I could possibly talk to about these thoughts was a doctor,” Moe said. “There were multiple instances where I wanted to ask a  care provider about these thoughts I was having, but every time I ultimately decided not to say anything because I thought they would ask biased questions or make assumptions about me.”

After his first year of medical school, with the help of Sandra Stover, MD, an assistant professor in the Department of Family Medicine and Biobehavioral Health, Moe developed an online, anonymous survey which he sent to registration employees at clinics around Minnesota after gaining approval from their clinic managers in order to gather information about their materials and resources available to patients, the physical space of the clinic and LGBTQ-specific services.

“I decided after my first year of medical school to pursue research that looked at those barriers to access to primary care,” Moe said. “The literature is limited on LGBTQ health. And of the literature that does exist, it is primarily focused on provider-patient relations. Knowing that the healthcare experience starts the moment you walk in the door, there are so many other factors beyond this that portray a practice’s inclusivity of all different patient populations.”

He found that 51% of respondents claimed to rarely or never interact with patients from the LGBTQ community, but most believed that their clinics would be considered welcoming.

“Members of the LGBTQ community are everywhere, so it shows the lack of recognition of these individuals’ identities in many areas,” Moe said. “A lot of the clinics offered STI and STD screenings, but that was the only service that had an adequate positive response. There is also a lack of knowledge about where to refer patients to so that they can get the services they need if the clinic does not have them, especially in cases of hormone treatment or gender-affirming procedures.”

In early 2020, he began presenting his work, first at a Duluth campus research symposium, then at the MAFP Innovation and Research Forum, then virtually at the American Academy of Family Physicians Conference.

“We were able to start a lot of really good conversations,” Moe said. “It was cool because whereas the Duluth symposium was a poster presentation, the Innovation and Research forum was more of a discussion with family physicians, residents and medical students interested in family medicine from across Minnesota.”

While undecided as to what track to follow in his residency, Moe intends to bring what he learned in this research into the field and to continue building from it.

“No matter what my future practice looks like or where it is, I very much want to be able to provide a space where no matter what a patient’s identities or backgrounds are, they are able to be their whole self so I can provide the care they need,” Moe said. “I would particularly like to be in a rural setting, just based on my own experiences.”

The next steps for this ongoing project include continuing to spread awareness about his findings as well as finding a medium for tangible change within rural clinics.

“I just wanted to raise awareness about the findings and to start a conversation,” Moe said. “But now, as I start residency, I'd like to build off this study and potentially go to rural clinics or build an educational platform for them with recommendations for their facilities. This was just an initial look as to where we are lacking, so I know where to go next with further research.”