"Oral sex? Anal sex? Fetishes?" These are questions on the patient intake form at AlphaBetterCare, an LGBT-friendly primary care practice owned and operated by Howard Grossman, MD.
"If you don't ask people, they're not going to tell you. If you make assumptions about people's sex lives, you miss things," Grossman says. "People put themselves at risk when they get involved with things they haven't been educated about."
With decades of HIV-focused internal medicine experience, Grossman set out to build a practice targeting lesbian, gay, bisexual, and transgender patients. These patients, he said, have often avoided doctors, many times because they worried about negative or judgmental attitudes of clinicians. With that focus he opened offices in midtown Manhattan as well as Millburn, N.J.
But Grossman didn't start out treating patients in two of the most affluent neighborhoods in the U.S. He trained at a public hospital in Brooklyn during the early 1980s in the early days of the HIV epidemic. That whetted his appetite for working with underserved populations. Along the way he has taken a right-to-die case to the Supreme Court, and served a term running the American Academy of HIV Medicine.
Now, he's focused on open communication in primary care. "When you get into these intimate details with people and they know they can talk to you about anything, then they're much more likely to be honest about all the rest of the stuff," he says. "I talk the same way about weight."
Though these questions might seem uncomfortable, Grossman says talking about people's sex lives can be a jumping-off point. "Then they're telling you about their work lives, how busy they are, how they don't have time for sex, we're talking about their relationships, their use of drugs and alcohol. It actually opens the door to lots of other conversations."
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