Selected Podcast
LGBTQ+ Healthcare Leader, Compassionate, Equitable and Inclusive Care for all Patients
Compassionate, inclusive care is imperative for any health facility. Dr. Arthur Dominguez, Jr., Chief Nursing Officer at Sierra Vista Regional Medical Center, discusses LGBTQ+ healthcare.
Featuring:
Arthur Dominguez Jr., DNP, MSN, RN
Art Dominguez, Jr. joined Sierra Vista Regional Medical in the Fall of 2017 as chief nursing officer. Art is responsible for the more than 300 registered nurses at Sierra Vista as well as the overall clinical quality of the hospital. Art is an accomplished nurse leader in a variety of healthcare settings, with many years of experience in patient care and clinical excellence and exceptional interpersonal skills. Most recently, Art served as assistant CNO at Desert Regional Medical Center in Palm Springs. During his nine years at DRMC, he also served as the interim director of the hospital’s 31-bed progressive care unit, was the house supervisor, and worked as a nurse in the emergency department/trauma and intensive care units. For two years, he worked at St. Mary’s Medical Center in San Francisco as an emergency department nurse. Prior to that, he was a critical care transport nurse for American Medical Response in the Riverside/Palm Springs area. Before that, he worked at La Quinta Surgery Center in La Quinta, Calif., as a pre-op, circulating and PACU nurse. Art earned his associate’s degree in nursing at College of the Desert in Palm Desert, Calif., his master’s degree in nursing leadership and management from Walden University and currently is a candidate for his doctorate of nursing practice from Walden University. Transcription:
Prakash Chandran (Host): This program is community service and is not intended to be a substitute for medical advice. Listeners having questions about their health should make an appointment to see their personal physician. Any opinions or statements made during the program are those of the individuals or physicians making the statements and are not the opinions or statements of the hospital.
It is so important to provide care that is compassionate, equitable and inclusive for all patients including our LGBTQ community. Today, we’ll be talking about how Sierra Vista Regional Medical Center and Twin Cities Community Hospitals have been really proactive about this. Here with us to discuss is Dr. Arthur Dominguez, Jr. DNP, Chief Nursing Officer At Sierra Vista Regional Medical Center. Dr. Dominguez, thank you so much for educating us today.
Arthur Dominguez, Jr., DNP, MSN, RN, CEN, CPEN, TCRN, CCRN, CENP (Guest): Thank you for the opportunity Prakash.
Host: Of course. So, let’s get started by learning a little bit about this program that I’ve been hearing so much about. It’s the LGBTQ Plus Healthcare Equality Advisory Council.
Dr. Dominguez: Yeah, absolutely. So, we started the LGBTQ Plus Advisory Council which was actually started a little over a year and a half ago with Twin Cities and now have joined with Sierra Vista, so we have market approach across the central coast in California. Our goal, our vision, better yet is for culturally competent and patient and family centered care for the lesbian, gay, bisexual, transgender, questioning or queer plus community and we really have a mission and a charter to strive for the premiere provider of healthcare services on the central coast and by doing that, we have various plans and goals that we have set in place.
Some of it being providing explicit and focused leadership from our hospital administration and team of the medical staff, becoming a public proponent and protector of all human rights, providing training and education at both Sierra Vista and Twin Cities, both for the team members, the community and our staff and then leveraging that expertise and perspective to the LGBTQ plus community.
The council consists of community members, healthcare providers, and both team members of Sierra Vista Regional Medical Center and Twin Cities Community Hospital as well.
Host: I can’t tell you how important it is that a program like this or a council like this exists especially in the time that we exist in right now. Can you talk to us a little bit about how long this program has been around. I know you said it started at Twin Cities but tell us when it started there and why you feel it is so important to this community.
Dr. Dominguez: So, the LGBTQ Plus Advisory Council actually started at Twin Cities probably close to two year ago as they started their venture towards their healthcare equality index designation at which point, Sierra Vista close to a year and a half ago, shortly after I started at Sierra Vista, we decided to start our healthcare equality index journey as well. We found that between the two hospitals rather than have two different councils focused on two different things, it made best sense for us to do a community and an area approach since we are sister facilities. The importance of it is to ensure that all people despite gender identity whether you are gay, transgender, bisexual or what that may be, have affordable and equitable healthcare. And our goal really is to ensure that we are treating all people the same. And that there is no discrimination both at the medical level but raising awareness and education in the community as well.
So, we strive to be a place for those who may have some concerns about any kind of healthcare or ill interactions or things that may occur at other organizations who may not have the training that we have to feel comfortable and welcome at our facilities.
Host: Yeah as mentioned, it’s so refreshing to hear that there is a focused program on this, and it sounds like it’s something that is measured. He mentioned the Healthcare Equality Index. Can you speak a little bit about that specifically?
Dr. Dominguez: Sure, so the healthcare equality index actually is through the Human Rights Campaign Foundation which honors and records facilities using LGBTQ Plus inclusion. In order to be and apply for the Healthcare Equality Index there’s a scoring criteria which is broken down into four different domains. One domain consists of nondiscrimination and staff training. The second one is patient services and support. The third is employee benefits and policies. And the fourth one is patient and community engagement. And as you go through the scoring system, there was last year I think there was a total of 626 different surveys that were submitted through Human Rights Campaign for the Healthcare Equality Index and as years and years go on, they are getting more and more applicants.
But the entire process probably takes – it’s a year’s worth long of training and education and preparation and the application process is – it’s beneficial in that it is very time consuming because there is so much attention to detail in there. And it takes the entire team probably a few months to upload and ensure that we have all the elements and need criteria to meet our Healthcare Equality Index goals as we strive to be 100% with our scoring metrics at both organizations.
Host: Right so, if I’m understanding this correctly, it’s kind of like this way to keep you honest about that constant conversation or level of care that you provide with your patients and it’s a way to tangibly measure that. Is that correct?
Dr. Dominguez: So, the ombudsman at Sierra Vista and at Twin Cities each facility have their own ombudsman team for lack of better words and our goal really is to ensure that the LGBTQ Plus community has a right and ensures that they are free from abuse, a right to be treated with respect, a right to privacy, a right to participate in their care equally, a right to visitations and an ability and right to be fully informed and to be active participants in their healthcare and to feel safe and comfortable in the care that they are receiving at both facilities. So, our goal really is in an ombudsman ensuring if there’s anything that were to come up, that we are constantly advocating for LGBTQ Plus community and visitors that come and see our facilities.
Now with regards to patient navigation, I’m currently the transgender patient navigator at Sierra Vista Regional Medical Center. I went to a three day seminar which by no means makes me a complete expert in transgender care, but it provided me a lot of information towards ensuring that we provide an affirming and comfortable place for transgender patients to receive their care at Sierra Vista Regional Medical Center. At which point, if there’s any patient that would come up or visit Twin Cities Regional Hospital, they know that they can actually give me a phone call as well and I can help them navigate if there are any questions that are coming up.
Host: Yeah, I want to get into that a little bit more. But before I do, just specifically an ombudsman or a patient navigator like yourself; is that something that an LGBTQ patient would be assigned on their first visit, like tell me a little bit about the process of how they are either paired or how they advocacy works.
Dr. Dominguez: Sure. So, if an LGBTQ Plus patient comes in and has a request for ombudsman, so we have various information and flyers both at registration and the emergency department, main admitting to share that there is an LGBTQ Plus Ombudsman and if they feel like they would like to have an ombudsman representative that’s when they would get in contact with us and then we would then show up and offer our services and support for them.
With regards to transgender navigation, if there’s anybody who is in the facility and the point is for it to be a seamless process and the treatment should be no different than any other patients. So, there shouldn’t be a lot of for lack of better words, confusion or necessarily specialized care or treatment because it should be the same way we treat everyone of our patients. And so, if there are questions that come up from team members, which is the majority of where the questions are coming from, of what do I call this person, how do I – when I’m engaging with them, what are some things that I should or should not say and it has nothing to do with really should or shouldn’t, it is making sure that we are using their affirming pronouns which I will be touching on in a little bit. But ensuring we are treating them truly with dignity and respect and treating their medical reason for them being there and not getting focused on other areas of their personal being that being they are LGBTQ status.
Host: I think one of the most important things that you said there is that the care should be no different, right, there should be no confusion or distinction between care between patients and to make that as seamless as possible. So, that’s something that I really appreciated there. Talking a little bit more about yourself as a transgender patient navigator; I want to unpack the affirming pronouns because, even myself, I have friends that are LGBTQ, they fall within that community and I find it difficult just to keep track – because at maybe one part of their life, they were referred to with one pronoun and now they’re referred to as another. It can be confusing. So maybe talk a little bit about that and how you train your staff.
Dr. Dominguez: Sure. So, the reason why we like to use affirming pronouns versus preferred, so the old methodology used to be preferred pronouns which gives somebody the option of using a pronoun or not. An affirming pronoun would be – it removes that option and let’s people know that this is what I am affirming, and these are my pronouns. So, for an example, it’s not abnormal for me to introduce myself in group settings and say my name is Arthur Dominguez, I’m a gay cisgender male and my affirming pronouns are he, him, his. Breaking that down, so cisgender means that I identify with the gender I was assigned at birth, so when I was born, I was assigned male at birth and I still identify and my pronouns are he, him, his. So, I still identify as a male. So I would be cisgender. Transgender would be opposite. So, may have been somebody who was assigned male at birth but identifies as female transgender. Affirming pronouns he, him, his, these are my gender identity of who I identify as, as a male. So, there is he, him, his is often for males. There is she, her, hers for females and then there is they, them, theirs and these are the plural pronouns which – these are probably the ones that people have the most difficulty with and these are those who are outside of the gender binary and in the state of California we actually have a nonbinary identification on our drivers license that started in January of this year which is gender X. So, if people are looking through driver’s licenses, they may start seeing M for male, F for female and X which is nonbinary. Which those ones, they don’t affirm as either male or female. So, we would refer to them as their or them versus he or she.
And it’s really important that we don’t make an assumption, though I have the appearance, the exterior appearance of male; it’s important for somebody to ask and by someone raising and saying what their affirming pronouns, shows that you are an ally to them, and they may feel more comfortable sharing what those affirming pronouns are or asking them. My name is Art, my affirming pronouns are he, him, his and then that gives them the opportunity to respond back and say maybe their name is Mark and their affirming pronouns are she, her, hers. So, then I have a respect and an ability to then communicate and assure that I’m using pronouns that are comfortable to that person in that particular setting. And then I’m constantly showing respect during our communication and conversation.
Host: Absolutely. I mean, thank you so much for the education and just the terminology around even just what an affirming pronoun is because it’s something that I really haven’t heard kind of categorized in that way. And I’ve even noticed with some of my friends, they’ve started putting it in their affirming pronouns in their email signatures. So, I know it’s becoming more of a thing and I think it’s like you said, it’s a sign that you are an ally with that person when you are able to affirm what their pronoun is and kind of state and also ask what theirs are. In wrapping up here, there’s a lot that we can talk about, but I want to get to PEP which is what I’m reading about is the postexposure prophylaxis and I want to ask you why it’s important to make the LGBTQ community aware about this protocol.
Dr. Dominguez: Yeah, so this is really important, and it was actually very exciting for us to implement at both facilities. So, first dose of postexposure prophylaxis or for short is PEP to start is now available in the Emergency Departments of both Twin Cities and Sierra Vista Regional. It normally consists of three anti-HIV drugs from two different classes. And so the importance of this is twofold.
So, for anybody who fears they may have had a high risk exposure whether that be protected sex or maybe a condom broke or somebody who had that instance where they had unprotected sex and found out that the person was HIV positive or for healthcare providers who work in high risk, high exposure potential areas where a splash or a needle stick, now a splash are very low rate for HIV transmission, but somebody who may have gotten a needle stick from somebody who is HIV positive or somebody who is high risk who may be HIV positive. This now allows us the opportunity to give a first dose postexposure prophylactic treatment where we give one pill in the Emergency Department at which point which is followed with a regimen depending on the exposure and the physician who is prescribing over a certain amount of days to ensure – not necessarily ensure but to help protect and as an effort to not become HIV positive.
And so, it really is important to get these – the first dose. The goal is really should be within 24 hours but less than 72 is ideal. And the sooner we have that first dose of postexposure prophylactic medication administered or given orally, it decreases the risk of them seroconverting from HIV negative to HIV positive. So, it can be – those living with HIV and AIDS, it is a lot different now than it was in the 80s and people are living long, full, healthy lives. It decreases the risk dramatically of seroconversion from HIV negative status to an HIV positive status.
Host: Yeah, I was reading about that and it’s so good to know that you have this measure in place so they can live that happy, healthy life and not go from negative to positive there. It’s amazing how far technology has come. So, I just want to thank you so much for your time Dr. Dominguez on educating us on this important issue of LGBTQ Plus healthcare. Is there anything else you want to leave our audience with before we sign off?
Dr. Dominguez: I would just say thank you for your time and thank you for the conversation. This week is rather exciting for us being the last week of March. It’s the LGBTQ Plus Health Awareness Week. So, we are really focusing on raising health and awareness for LGBTQ Plus community obviously throughout the year, but a heightened focus and attention this year and ensuring that those who are getting their care and treatment both at the Primary Care and then just knowing that we are there to treat them equally and without bias at either facility.
Host: Absolutely and it’s been a wonderful and very informative conversation for me personally. So, thank you so much. Everyone else, for a referral to a board-certified physician or just to learn more about all of this, please call the Sierra Vista Regional Medical Center and Twin Cities Community Hospital Physician Referral Line at 866-966-3680. My guest today has been Dr. Arthur Dominquez. I’m Prakash Chandran. Thank you so much for listening.
Prakash Chandran (Host): This program is community service and is not intended to be a substitute for medical advice. Listeners having questions about their health should make an appointment to see their personal physician. Any opinions or statements made during the program are those of the individuals or physicians making the statements and are not the opinions or statements of the hospital.
It is so important to provide care that is compassionate, equitable and inclusive for all patients including our LGBTQ community. Today, we’ll be talking about how Sierra Vista Regional Medical Center and Twin Cities Community Hospitals have been really proactive about this. Here with us to discuss is Dr. Arthur Dominguez, Jr. DNP, Chief Nursing Officer At Sierra Vista Regional Medical Center. Dr. Dominguez, thank you so much for educating us today.
Arthur Dominguez, Jr., DNP, MSN, RN, CEN, CPEN, TCRN, CCRN, CENP (Guest): Thank you for the opportunity Prakash.
Host: Of course. So, let’s get started by learning a little bit about this program that I’ve been hearing so much about. It’s the LGBTQ Plus Healthcare Equality Advisory Council.
Dr. Dominguez: Yeah, absolutely. So, we started the LGBTQ Plus Advisory Council which was actually started a little over a year and a half ago with Twin Cities and now have joined with Sierra Vista, so we have market approach across the central coast in California. Our goal, our vision, better yet is for culturally competent and patient and family centered care for the lesbian, gay, bisexual, transgender, questioning or queer plus community and we really have a mission and a charter to strive for the premiere provider of healthcare services on the central coast and by doing that, we have various plans and goals that we have set in place.
Some of it being providing explicit and focused leadership from our hospital administration and team of the medical staff, becoming a public proponent and protector of all human rights, providing training and education at both Sierra Vista and Twin Cities, both for the team members, the community and our staff and then leveraging that expertise and perspective to the LGBTQ plus community.
The council consists of community members, healthcare providers, and both team members of Sierra Vista Regional Medical Center and Twin Cities Community Hospital as well.
Host: I can’t tell you how important it is that a program like this or a council like this exists especially in the time that we exist in right now. Can you talk to us a little bit about how long this program has been around. I know you said it started at Twin Cities but tell us when it started there and why you feel it is so important to this community.
Dr. Dominguez: So, the LGBTQ Plus Advisory Council actually started at Twin Cities probably close to two year ago as they started their venture towards their healthcare equality index designation at which point, Sierra Vista close to a year and a half ago, shortly after I started at Sierra Vista, we decided to start our healthcare equality index journey as well. We found that between the two hospitals rather than have two different councils focused on two different things, it made best sense for us to do a community and an area approach since we are sister facilities. The importance of it is to ensure that all people despite gender identity whether you are gay, transgender, bisexual or what that may be, have affordable and equitable healthcare. And our goal really is to ensure that we are treating all people the same. And that there is no discrimination both at the medical level but raising awareness and education in the community as well.
So, we strive to be a place for those who may have some concerns about any kind of healthcare or ill interactions or things that may occur at other organizations who may not have the training that we have to feel comfortable and welcome at our facilities.
Host: Yeah as mentioned, it’s so refreshing to hear that there is a focused program on this, and it sounds like it’s something that is measured. He mentioned the Healthcare Equality Index. Can you speak a little bit about that specifically?
Dr. Dominguez: Sure, so the healthcare equality index actually is through the Human Rights Campaign Foundation which honors and records facilities using LGBTQ Plus inclusion. In order to be and apply for the Healthcare Equality Index there’s a scoring criteria which is broken down into four different domains. One domain consists of nondiscrimination and staff training. The second one is patient services and support. The third is employee benefits and policies. And the fourth one is patient and community engagement. And as you go through the scoring system, there was last year I think there was a total of 626 different surveys that were submitted through Human Rights Campaign for the Healthcare Equality Index and as years and years go on, they are getting more and more applicants.
But the entire process probably takes – it’s a year’s worth long of training and education and preparation and the application process is – it’s beneficial in that it is very time consuming because there is so much attention to detail in there. And it takes the entire team probably a few months to upload and ensure that we have all the elements and need criteria to meet our Healthcare Equality Index goals as we strive to be 100% with our scoring metrics at both organizations.
Host: Right so, if I’m understanding this correctly, it’s kind of like this way to keep you honest about that constant conversation or level of care that you provide with your patients and it’s a way to tangibly measure that. Is that correct?
Dr. Dominguez: So, the ombudsman at Sierra Vista and at Twin Cities each facility have their own ombudsman team for lack of better words and our goal really is to ensure that the LGBTQ Plus community has a right and ensures that they are free from abuse, a right to be treated with respect, a right to privacy, a right to participate in their care equally, a right to visitations and an ability and right to be fully informed and to be active participants in their healthcare and to feel safe and comfortable in the care that they are receiving at both facilities. So, our goal really is in an ombudsman ensuring if there’s anything that were to come up, that we are constantly advocating for LGBTQ Plus community and visitors that come and see our facilities.
Now with regards to patient navigation, I’m currently the transgender patient navigator at Sierra Vista Regional Medical Center. I went to a three day seminar which by no means makes me a complete expert in transgender care, but it provided me a lot of information towards ensuring that we provide an affirming and comfortable place for transgender patients to receive their care at Sierra Vista Regional Medical Center. At which point, if there’s any patient that would come up or visit Twin Cities Regional Hospital, they know that they can actually give me a phone call as well and I can help them navigate if there are any questions that are coming up.
Host: Yeah, I want to get into that a little bit more. But before I do, just specifically an ombudsman or a patient navigator like yourself; is that something that an LGBTQ patient would be assigned on their first visit, like tell me a little bit about the process of how they are either paired or how they advocacy works.
Dr. Dominguez: Sure. So, if an LGBTQ Plus patient comes in and has a request for ombudsman, so we have various information and flyers both at registration and the emergency department, main admitting to share that there is an LGBTQ Plus Ombudsman and if they feel like they would like to have an ombudsman representative that’s when they would get in contact with us and then we would then show up and offer our services and support for them.
With regards to transgender navigation, if there’s anybody who is in the facility and the point is for it to be a seamless process and the treatment should be no different than any other patients. So, there shouldn’t be a lot of for lack of better words, confusion or necessarily specialized care or treatment because it should be the same way we treat everyone of our patients. And so, if there are questions that come up from team members, which is the majority of where the questions are coming from, of what do I call this person, how do I – when I’m engaging with them, what are some things that I should or should not say and it has nothing to do with really should or shouldn’t, it is making sure that we are using their affirming pronouns which I will be touching on in a little bit. But ensuring we are treating them truly with dignity and respect and treating their medical reason for them being there and not getting focused on other areas of their personal being that being they are LGBTQ status.
Host: I think one of the most important things that you said there is that the care should be no different, right, there should be no confusion or distinction between care between patients and to make that as seamless as possible. So, that’s something that I really appreciated there. Talking a little bit more about yourself as a transgender patient navigator; I want to unpack the affirming pronouns because, even myself, I have friends that are LGBTQ, they fall within that community and I find it difficult just to keep track – because at maybe one part of their life, they were referred to with one pronoun and now they’re referred to as another. It can be confusing. So maybe talk a little bit about that and how you train your staff.
Dr. Dominguez: Sure. So, the reason why we like to use affirming pronouns versus preferred, so the old methodology used to be preferred pronouns which gives somebody the option of using a pronoun or not. An affirming pronoun would be – it removes that option and let’s people know that this is what I am affirming, and these are my pronouns. So, for an example, it’s not abnormal for me to introduce myself in group settings and say my name is Arthur Dominguez, I’m a gay cisgender male and my affirming pronouns are he, him, his. Breaking that down, so cisgender means that I identify with the gender I was assigned at birth, so when I was born, I was assigned male at birth and I still identify and my pronouns are he, him, his. So, I still identify as a male. So I would be cisgender. Transgender would be opposite. So, may have been somebody who was assigned male at birth but identifies as female transgender. Affirming pronouns he, him, his, these are my gender identity of who I identify as, as a male. So, there is he, him, his is often for males. There is she, her, hers for females and then there is they, them, theirs and these are the plural pronouns which – these are probably the ones that people have the most difficulty with and these are those who are outside of the gender binary and in the state of California we actually have a nonbinary identification on our drivers license that started in January of this year which is gender X. So, if people are looking through driver’s licenses, they may start seeing M for male, F for female and X which is nonbinary. Which those ones, they don’t affirm as either male or female. So, we would refer to them as their or them versus he or she.
And it’s really important that we don’t make an assumption, though I have the appearance, the exterior appearance of male; it’s important for somebody to ask and by someone raising and saying what their affirming pronouns, shows that you are an ally to them, and they may feel more comfortable sharing what those affirming pronouns are or asking them. My name is Art, my affirming pronouns are he, him, his and then that gives them the opportunity to respond back and say maybe their name is Mark and their affirming pronouns are she, her, hers. So, then I have a respect and an ability to then communicate and assure that I’m using pronouns that are comfortable to that person in that particular setting. And then I’m constantly showing respect during our communication and conversation.
Host: Absolutely. I mean, thank you so much for the education and just the terminology around even just what an affirming pronoun is because it’s something that I really haven’t heard kind of categorized in that way. And I’ve even noticed with some of my friends, they’ve started putting it in their affirming pronouns in their email signatures. So, I know it’s becoming more of a thing and I think it’s like you said, it’s a sign that you are an ally with that person when you are able to affirm what their pronoun is and kind of state and also ask what theirs are. In wrapping up here, there’s a lot that we can talk about, but I want to get to PEP which is what I’m reading about is the postexposure prophylaxis and I want to ask you why it’s important to make the LGBTQ community aware about this protocol.
Dr. Dominguez: Yeah, so this is really important, and it was actually very exciting for us to implement at both facilities. So, first dose of postexposure prophylaxis or for short is PEP to start is now available in the Emergency Departments of both Twin Cities and Sierra Vista Regional. It normally consists of three anti-HIV drugs from two different classes. And so the importance of this is twofold.
So, for anybody who fears they may have had a high risk exposure whether that be protected sex or maybe a condom broke or somebody who had that instance where they had unprotected sex and found out that the person was HIV positive or for healthcare providers who work in high risk, high exposure potential areas where a splash or a needle stick, now a splash are very low rate for HIV transmission, but somebody who may have gotten a needle stick from somebody who is HIV positive or somebody who is high risk who may be HIV positive. This now allows us the opportunity to give a first dose postexposure prophylactic treatment where we give one pill in the Emergency Department at which point which is followed with a regimen depending on the exposure and the physician who is prescribing over a certain amount of days to ensure – not necessarily ensure but to help protect and as an effort to not become HIV positive.
And so, it really is important to get these – the first dose. The goal is really should be within 24 hours but less than 72 is ideal. And the sooner we have that first dose of postexposure prophylactic medication administered or given orally, it decreases the risk of them seroconverting from HIV negative to HIV positive. So, it can be – those living with HIV and AIDS, it is a lot different now than it was in the 80s and people are living long, full, healthy lives. It decreases the risk dramatically of seroconversion from HIV negative status to an HIV positive status.
Host: Yeah, I was reading about that and it’s so good to know that you have this measure in place so they can live that happy, healthy life and not go from negative to positive there. It’s amazing how far technology has come. So, I just want to thank you so much for your time Dr. Dominguez on educating us on this important issue of LGBTQ Plus healthcare. Is there anything else you want to leave our audience with before we sign off?
Dr. Dominguez: I would just say thank you for your time and thank you for the conversation. This week is rather exciting for us being the last week of March. It’s the LGBTQ Plus Health Awareness Week. So, we are really focusing on raising health and awareness for LGBTQ Plus community obviously throughout the year, but a heightened focus and attention this year and ensuring that those who are getting their care and treatment both at the Primary Care and then just knowing that we are there to treat them equally and without bias at either facility.
Host: Absolutely and it’s been a wonderful and very informative conversation for me personally. So, thank you so much. Everyone else, for a referral to a board-certified physician or just to learn more about all of this, please call the Sierra Vista Regional Medical Center and Twin Cities Community Hospital Physician Referral Line at 866-966-3680. My guest today has been Dr. Arthur Dominquez. I’m Prakash Chandran. Thank you so much for listening.