RI’s first LGBTQ-focused health clinic celebrates 2 years

Amy Nunn, professor of behavioral and social sciences and medicine, and Philip Chan, associate professor of medicine and behavioral and social sciences, co-founded Open Door Health in southwest Providence in March 2020 after the two began outlining ideas for a clinic to address the lack of health care specifically for the LGBTQ+ community in 2016. 

Today, the clinic has grown to offer primary care, gender-affirming care, STI care, COVID-19 testing and vaccinations. From its location at 7 Central St., Open Door Health has served over 3,500 patients to date, Nunn said. 

Open Door Health is a program under the Rhode Island Public Health Institute, a nonprofit focused on addressing public health challenges. Nunn is RIPHI’s executive director and Chan is its chief medical officer.

The idea for the clinic “emerged out of hearing from patients about their need for affirming primary care services. A lot of people felt they didn’t have a resource to turn to in this area,” Nunn said. 

From the beginning, the clinic has focused on patient accessibility, Nunn and Chan said. Chan described the clinic as “intentionally placed” in order to cater to the state’s large Latinx and LGBTQ+ community. 

“Our goal here is to be non-judgemental, accessible and open to everyone. We want to be in the community. We are located in one of the highest-need areas of the city,” Chan said. 

Creating an open space in the clinic starts from the top down, Chan said. An initial priority was placed on hiring those — from front desk workers to physicians — who had a respectful and non-judgemental approach to patient care, he added.

Warren Alpert Medical School student Fernando Ibanhes MD’22, who works at the clinic, described the space as “nothing like your typical dated and sterile medical office.” The welcoming atmosphere “is a statement to the clinic's mission to go above and beyond in providing a state-of-the-art facility for a community that has been historically forgotten,” he wrote in an email to The Herald.

Open Door Health’s commitment to accessibility goes beyond its physical space — the clinic’s financial structure is designed to cover costs if patients cannot pay, Nunn said. This flexible system reflects a “strong belief in providing services to everyone, regardless of ability to pay,” Chan added. 

The clinic embodies the intersection of health care, public health, research and education, according to Chan and Nunn. Research conducted at the clinic not only focuses on LGBTQ+ issues such as HIV prevention, but also on how to reach more patients in need through advertising, Nunn and Chan said. Nunn oversees social research, while Chan oversees clinical research. 

The clinic focuses on conducting research in a clinical setting. For example, the clinic is actively researching how to implement recent innovations in sexual healthcare such as the “one-pill, once-a-day” treatment for HIV and point-of-care testing for STDs, Nunn said.

“STIs are exponentially increasing across the U.S., including here in Rhode Island,” Chan said. “It’s incredibly fulfilling to be able to offer direct services and make a difference in the community.”

Offering walk-in, same-day STI testing is important for patient accessibility at Open Door Health, according to Chan. Twenty to 25% of walk-ins test positive for an STI, he added. 

“We are reaching the population that needs it — those who may not otherwise test,” Chan said. 

Beyond clinical research, Open Door Health has focused on social research to ensure their services are reaching vulnerable populations. The clinic has recently begun advertising on dating apps, Google Ads, Facebook and Instagram, Nunn said. 

“We want to understand what actually works to get vulnerable people in for care,” Nunn said. “How can we best enhance communications with those who we believe could be potential patients?”

The clinic is the only “dedicated, LGBTQ+ primary care clinic in Rhode Island,” Chan said. But beyond being the only health care provider of its kind in the state, Open Door Health is special because of the people, Ibanhes said, describing the staff as a “formidable team.”

“Each (staff member) brings with them decades of proven contributions to the improvement of the health of LGBTQ+ individuals,” Ibanhes added. Nunn and Chan described the process of establishing and running the clinic as a team effort, citing the influence of operations and programs manager Cassie Sutton Coats, RIPHI Chief Financial Officer Lynne Malone and nurse practitioner Mary Dromgoole in bringing accessibility into practice. 

Nunn emphasized the impact the clinic has had on patient lives, adding that physicians at the clinic have received positive notes from patients, especially those who identify as transgender. 

One patient wrote they were afraid to walk into a clinic due to previous discrimination, but staff at Open Door Health such as Dromgoole “made them feel safe again,” according to Nunn. Experiences such as this, Nunn said, highlight the importance of culturally-tailored health services. 

“A lot of people may not get healthcare at all if they do not get care here. This really motivates me to keep going,” Nunn said. 

Staff at Open Door Health said standalone health care facilities can have unique relationships with the community.

“We live in times of big American healthcare,” Ibanhes wrote. Dromgoole described clinics such as Open Door Health as having a “finger on the pulse of the community,” arguing that local clinics are more in touch with the trends within their communities. 

According to Dromgoole, when Open Doors first opened, predominantly local patients accessed the clinic because of location, accessibility and familiarity. But now people come in from all over Rhode Island and neighboring states, she said.

“I believe and hope that the success of Open Door Health will prove to patients and health care providers that other models of health care are still possible. … Good health really starts in the communities and in small clinics that are genuinely attuned to real needs of its patients,” Ibanhes wrote. “This is what (Open Door Health) is all about.”