CASE SCENARIO

As someone who takes pride in maintaining meaningful patient-clinician relationships, I was upset to learn that a 38-year-old Black patient, whom I have seen multiple times in my clinic, requested a referral for contraception management. She has one living child, a previous pregnancy termination, and a history of obesity, hypertension, and depression. I have extensive experience in contraceptive management and believe that assisting patients with sexual and reproductive health care is a priority in primary care.

In a previous visit, I had suggested an intrauterine device as a potential contraception method, but she seemed ambivalent about the recommendation at the time. On reflection, I did not adequately discuss her sexual and reproductive health goals and contraceptive method preferences. I also did not consider her experiences of discrimination in health care, history of sexual trauma, or other issues that may impede her ability to trust clinicians, especially regarding sensitive topics.

As a male physician from a different cultural background, could I have unintentionally created a perception of a hidden agenda? How can I improve my approach to sexual and reproductive health care to understand patients' experiences and better meet their needs?