Belonging: Why DEI is the vital sign family medicine can’t ignore

By Dr. Julia Chronopoulos 

When we think of the essentials of family medicine, we usually picture the basics: blood pressure cuffs, stethoscopes, immunization schedules, and routine screenings. But there is another vital sign that dictates a patient’s health long before they ever step into an exam room: belonging. 

The intersection of health care, Diversity, Equity, and Inclusion (DEI) is not just a trendy buzzword; it is a clinical necessity. In family medicine, we treat generations of families from birth to end-of-life. Understanding how a patient’s identity shapes their health outcomes is just as, if not more important, than knowing their genetic history.

The Intersection: Where Identity Meets Health Outcomes 

Health equity means recognizing that people cannot achieve their best health if systemic barriers stand in their way. In family medicine, a one-size-fits-all approach inevitably leaves people behind. 

Consider how different intersections of identity impact care: 

• The Trust Gap: Marginalized communities—including Indigenous, Black, and 2SLGBTQ+ individuals—historically and presently face discrimination in health care, leading to delayed care and worsened outcomes. 

• The Social Determinants of Health: Factors like race, socioeconomic status, and gender identity heavily influence a person’s access to clean water, nutritious food, safe housing, a source of financial support, and unbiased medical advice. 

As family physicians and clinic staff, our job isn’t just to treat the symptom in front of us, but to understand the context of the person living with it. 

Cultivating Safety: 3 Zero-Cost Tips for a 2SLGBTQ+ Welcoming Clinic 

Creating an inclusive environment for Two-Spirit, Lesbian, Gay, Bisexual, Transgender, Queer, and additional sexually and gender-diverse (2SLGBTQ+) patients does not require a massive budget overhaul or expensive consultants. It starts with intentional, daily culture shifts. 

Here are three simple, powerful changes your clinic can implement today without spending a dime: 

1. Lead with Your Own Pronouns

Normalizing pronoun sharing takes the burden off gender-diverse patients to explain themselves. It signals that your clinic understands gender identity is not an assumption. 

• How to do it: Add your pronouns (e.g., she/her, they/them, he/him) to your email signature, your clinic ID badge, or simply introduce yourself with them during patient intakes: “Hi, I’m Dr. Taylor, my pronouns are she/her, and I’ll be taking care of you today.”
  
  

2. Swap to Gender-Neutral Language by Default

The language we use out of habit can accidentally alienate patients or make assumptions about their lives and families. Shifting to gender-inclusive phrasing costs nothing but makes a massive psychological difference. 

• How to do it: * Instead of asking a woman, “Do you have a husband?” ask, “Do you have a partner or spouse?” 

• Instead of addressing a waiting room with, “Good morning, ladies and gentlemen,” try, “Good morning, everyone.” 
• Instead of assuming a child’s parents are a “mom and dad,” use the word “parents” or “guardians.”
  
  

3. Affirm and Document Chosen Names Instantly

A patient’s legal documents may not match who they truly are. Being called by a deadname (a birth name that a trans or non-binary person no longer uses) at the front desk can cause severe anxiety and deter patients from returning. 

• How to do it: During check-in or on intake forms, ensure there is a clear space for “Chosen Name” and “Pronouns.” Train all staff to look for this field first. If a mistake happens—because we are human—correct it quickly, apologize briefly, and move forward: “I’m sorry, I meant Sam. As I was saying…” 

The Bottom Line: Inclusion is not about perfection; it is about direction. By making these small, cost-free adjustments, your clinic can transform from a place of anxiety into a sanctuary of healing. 

What is one small change your team has made that had an unexpectedly large impact on patient trust?