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In this style of managed care, enrolling as many

patients as possible is the only way to make money. The
larger the number of people on your "panel" (patients
signed up with you), the more money you make. By signing
up a patient, the physician takes on the responsibility
of caring for that patient. Since there are only so many
hours in the day, seeing patients efficiently and quickly is
the key.

Obviously, then, there is an economic disadvantage to

being known as an expert in treating patients with high-
maintenance conditions. While it is unethical (and rare) for
a physician to refuse to see sick patients, some physicians
do apply subtle pressures to convince a sick patient to
change physicians. Therefore, some of the advice you will
read in this book is designed to help you present yourself
to your health care practitioner as someone who will
probably not be an exceptionally demanding patient.

Clinics and government-supported care. Many people

with alternative sexualities have lifestyles that do not
permit them to obtain private health care, even through
an HMO. If you are such a person, you may be getting
your medical care in a clinic, or through a government-
supported program such as Medicaid.

Free clinics are usually supported by various charities

and/or religious groups. They usually have a mission: the
homeless, the working poor, women, drug addicts, etc.
These clinics are usually understanding about everyone's
blemishes and are accustomed to seeing sexual minorities.
They are usually quite tolerant, because they want the
target group to use the clinic. Even the religious groups
are fairly tolerant, sometimes even very tolerant.