Sometimes, providing compassionate care is about recognizing the limits of your own understanding.
As a psychiatrist, Brian Rothberg, MD, knew the statistics surrounding health disparities in the LGBTQ community. But it wasn’t until he began leading group therapy sessions for people identifying as transgender that he realized just how much he had to learn. So when his colleagues presented him with an award they coined the “LGBTQ Ally Award,” he was moved to tears.
“I’ll be the first to admit that I was out of my element,” he said. “I just knew I wanted to help, but as an outsider, I wasn’t sure how I could.”
As associate practice director of the psychiatry outpatient clinic at University of Colorado Hospital, Dr. Rothberg plays an essential role at IMAGINEclinic, the hospital’s LGBTQ mental health clinic. Along with psychiatrist Robert Davies, MD, and third year resident Alexis Chavez, MD, he works to provide informed, compassionate mental health care for all members of the LGBTQ community in a safe and accepting environment.
Dr. Davies said Dr. Rothberg’s humble approach to his work in the LGBTQ clinic exemplifies compassionate care. “Working with transgender individuals was not something with which Brian had much experience, but he realized the importance of this work and openly acknowledged the limits of his experience and knowledge,” Dr. Davies said. “He has committed himself to this exceedingly underserved population and has been instrumental in the success of our clinic.”
“He has focused on the LGBT populations not because it is relevant to himself, but because he firmly believes in compassionate care for all people,” Dr. Chavez said.
Dr. Rothberg currently facilitates a solidarity support group for transgender individuals, a space that’s essentially changed his worldview. “Our conversations in group have made me think differently about how I speak, and I’m more aware of some of my own implicit bias,” he said. And he believes that overall, patients visiting the clinic have had a positive experience.
“The people I meet with in group were skeptical of me at first, which isn’t surprising given the discrimination and daily problems they face just going about their regular day,” he said. “I think—I hope—that my being present and willing to learn has helped to engender trust.”
“The patients in our therapy group have accepted Dr. Rothberg as ‘one of our own,’ despite having previous negative experiences with other providers,” said Dr. Chavez. “It’s a testament to how much he goes beyond what is expected so that he can provide what is most beneficial.” Since the clinic opened in the summer of 2016, the team has made strides toward their goal of becoming a valued community resource.
“Recently I happened to run into someone who is transgender in the community, and I mentioned my work at the IMAGINEclinic. They said, ‘I’ve heard about the clinic,’ which was meaningful to me. We’re still new but the word is getting out.”
Working with patient populations whose experiences are atypical can be challenging. But there’s real value in truly engaging to better understand the circumstances that directly affect physical and mental health.
“I’ve learned that you have to be okay with the fact you may say something wrong, and you have to be open to receiving that feedback,” he said. “I’m still afraid of saying something that’s not respectful but I’m finding it's an invaluable part of earning someone’s trust.”
Dr. Chavez said Dr. Rothberg has been focused on improving how he communicates with transgender patients. “Brian has sought out further instruction on the differences between gender identity, sexual orientation and gender expression,” she said. “He practices using these terms when supervising, and he also has taught his family these concepts at the dinner table.”
Dr. Rothberg is making a big impact, not just with the lives of his patients but also with his colleagues. Robert Feinstein, MD, has worked with Dr. Rothberg in clinic for 11 years and explained he is a valuable member of the team.
“His compassion for the underserved, and his capabilities and innovations for our group programs, make him a role model for all our trainees, staff and faculty,” Dr. Feinstein said. “His superb judgment and keen insights about integrating clinical outpatient services with a top-notch and unique educational program has been invaluable to me personally and the department. Our future's so bright because of his ongoing contributions.”
Dr. Chavez has also been impacted by Dr. Rothberg’s approach. “There is no doubt in my mind that I am a better clinician, group leader, and person because of Dr. Rothberg. He exemplifies what it means to be compassionate and models it in everything he does,” she said.
Dr. Rothberg is hopeful that in a small way, his efforts are helping connect the LGBTQ community with the medical community at large.
“There are so many people who don’t get medical care at all because of discrimination and misunderstanding,” he said. “I hope my efforts in trying to understand their situations helps them as individuals, and that I can help educate others about how we talk about gender expression and sexuality. Our words matter.”
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