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last chapter. In these systems, physicians are paid a set
fee for each patient every month, whether they see that
patient or not. Obviously, the physician with healthy
patients will make money, and the one with patients who
need frequent visits will lose money. Doctors, like most
of us, do not want to work harder than necessary. Thus,
a patient who looks as though she'll be demanding or
hard to work with may find it hard to find a welcoming
physician. HMO rules try to prevent doctors from refusing
patients who are sick, but there are ways around these
rules. Doctors may assume that a patient who is a member
of a sexual minority is likely to be difficult. (You may say
you wouldn't want a physician like that ­ but you probably
also don't want a physician who is too busy to give you
the time you need.) If the physician has to invest a lot of
time learning about your sexual lifestyle, whether or not
you are a "difficult" patient, the physician may choose to
be less than welcoming.
It is thus in your best interests, when choosing a
physician, to present yourself as sane, self-aware and
sensible. The following suggestions are not meant to teach
you how to be a good patient, nor do they imply that
sexual minorities are bad patients. Many sexual minorities
have avoided traditional health care for so long that they
do not know how the system works these days.
A good way to start is to ask others in your sexual
community for recommendations. If other practitioners
of your sexual behavior and/or lifestyle are happy with
their medical care, then it's a pretty good bet that you
will be, too. In addition, such referrals tend to reward
nonjudgmental physicians by sending them lots of new
patients.