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How can I better serve patients at my clinic?

Few clinics in the United States are fully prepared to care for women with female genital mutilation/cutting (FGM/C). Making modest changes to the way your clinic operates can make a big difference in how comfortable patients feel, increasing the likelihood they will return for continued care.

 

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  • Ask your team some broad questions to establish a baseline:
    • Do any of our patients come from communities that practice FGM/C? 1 
    • How do we care for patients with FGM/C?  
  • Create protocols for how to :
    • Provide care for pregnant women with FGM/C.
    • Address requests for re-infibulation.
    • Address concerns for children who may be at risk of FGM/C.
    • Refer to other health and social service providers, as appropriate.2 

training

  • Train your staff on how to identify FGM/C and treat complications.3 Encourage your staff to take this training course and use this visual reference learning tool from Arizona State University. 
  • Assign one team member to be the FGM/C "point-person" at the clinic, serving as the office's lead expert on  FGM/C. He/she should keep up with the latest training and educational opportunities, and standardize processes and protocols for treating FGM/C.4

 screening tools

  • Use this ICD-10 codes guide to help you bill for FGM/C-related services.
  • Add these questions on FGM/C on intake forms/medical history forms:
    • “Have you ever undergone genital cutting?”
    • “Is cultural cutting practiced in your community?”
  • Provide factsheets, such as our toolkit's general overview factsheet, for patients in examination rooms. Avoid placing the factsheets in waiting areas. Patients may be reluctant to pick them up and risk disclosing to a crowded room that they have undergone FGM/C. 
  • Recommend that members of your team to fill out our toolkit's screening tools for children or women to determine the best patient care plan.
  • Encourage your staff to document the type of FGM/C, any history of complications resulting from FGM/C, any prior pregnancies, and history of pelvic exams. Use our "care checklist" as your guide.

How can your clinic create a more welcoming environment? 

  • Offer the services of a professional translator/interpreter, preferably a woman.5
  • Make your team reflect the diversity of the community you serve.6
  • Create screening tools for other common health problems in your patient population (diabetes, for example).6
  • Ask your patient if she feels comfortable with others in the examination room (relatives and friends who may have accompanied her during the visit).6