I spend a lot of time thinking about words. Part of it is my cultural studies background. Part of it is a personal obsession with etymology and semiotics and self-reflection.
Words are power. Health is power.
Unfortunately, many people have less access to wellth, or health power, than others. They may have less access to healthcare because of finances or because of sociocultural ‘ism’s. ‘Ism’s, and other sociocultural factors of health inequity, get in the way of people receiving the healthcare they are hoping for, even before they walk in the clinic door. I’m talking about intake forms.
Since I first started practicing, I’ve included a question on my intake form that asks people what obstacles are getting in the way of their health. Usually, people respond by listing their work stress or their addiction to sugar, or some other behaviour that they indulge in that they believe to be unhealthy. Then one time, I had a patient answer ‘racism and homophobia’. At the time, it struck me as important, not just because racism and homophobia do present real lived obstacles to health and wellth, but also because they were the first person to explicitly identify social issues in their intake form. They certainly weren’t the first LGBTQ patient I’d had. Nor were they the first person of colour in my practice. I wondered, did other patients of mine not consciously experience these isms as having an impact on their health, or was there some way I wasn’t being explicit that I cared about these external social factors? In what ways was my intake form informing the patient about my philosophy of care?
Most people, when looking for a new healthcare provider, are looking for someone they can trust, someone who will understand their needs, their bodies, and their selves. This is why educators talk so much about empathy and rapport in therapeutic relationships. This is why marketers tell you that patients are looking for first person stories. Patients want to see themselves reflected in their healthcare provider. Rapport isn’t just about the health consumer experience however. For some people, it is the difference between regular care and discrimination in the doctor’s office. This is where the intake form matters.
The intake form is often the first contact a new patient has with a healthcare provider. Checkboxes and questions that inadequately or inappropriately reflect people are likely to suggest to those same people that they are not recognized, welcome, understood, or accepted.
My intake forms are always evolving and changing, just as I continue to evolve as a practitioner too. I’ve tried to make my latest versions more trans-positive and more reflective of the diversity of gender and its expression. Feel free to check out the latest versions of my intake forms here.