A cardiologist’s story: Why LGBTQ+ visibility is important in medicine
For Tony Pastor, MD, representation of the LGBTQ+ community in medicine is important for both healthcare professionals and patients. “Visibility is super important, especially within our queer community,” he says.
“Healthcare as an industry has a long history of discrimination of marginalized patients,” Dr. Pastor explains. The HIV epidemic led to heightened medical distrust among patients in the LGBTQ+ community. And they are still less likely to seek preventive care and treatment. “There’s data showing that LGBTQ+ patients are likely to have worse outcomes."
“There are a lot of patients who identify as LGBTQ+. Many of the physicians who were my mentors never got any formal training about how to take care of them,” he says. “The education that physicians receive in this area is a product of where they train. At the medical school I went to, I got nothing. In fact, I got inappropriate stuff at times.”
“I feel very passionate about the subject,” Dr. Pastor says. “Unless we provide better training, we’re going to be giving subpar care and ignoring a community that is high risk.”
Discovering a calling in cardiology
Pastor’s grandfather lived in Morocco, where he had rheumatic fever and was told he only had a couple of weeks to live. Prompted by the urgency of that news and seeking possible treatment, their family immigrated to Houston, Texas. His grandfather had an experimental, but lifesaving, aortic valve replacement by the pioneer cardiac surgeon, Michael DeBakey, MD. That sparked Pastor’s initial interest in medicine and in cardiology.
Dr. Pastor’s impressive career includes a residency at Baylor College of Medicine, where he was chief resident. He followed that with 2 cardiology fellowships — 1 in pediatrics at Boston Children’s Hospital, and a senior fellowship in adult congenital disease at Harvard Medical School.
Dr. Pastor now sees patients at Yale New Haven Hospital in Connecticut. Most of his patients are adults with congenital heart disease, meaning heart conditions they were born with. He also has a monthly clinic where he sees pediatric patients.
Out and proud as a gay doctor, working to increase LGBTQ+ visibility
“I had some lectures from an older physician who used antiquated and somewhat offensive terminology in talking about gay men. I was very triggered by it,” Dr. Pastor recalls. But during medical school, Pastor was “out and proud.” He and a friend started the first Gay-Straight Alliance at Baylor College of Medicine. They brought a proposal for the Alliance to the medical school, and the administration supported the idea.
During his residency, there was no formal training for physicians on caring for LGBTQ+ patients. So, Pastor, an openly gay resident, was tapped to give lectures to other residents about LGBTQ+ health. “It’s funny. I had to look up the stuff myself,” he recalls.
During the COVID-19 pandemic, Dr. Pastor and another cardiologist specializing in adult congenital heart diseases started a Facebook group for gay doctors. “It’s not just cardiologists. It’s every queer-identifying physician,” he says. The group now has over 6,000 members. “It just kind of blew up,” Pastor says. “We have moderators in every time zone.” They vet requests to ensure that group members are either physicians or in medical school.
Boosting inclusivity with a first-time LGBTQ+ social networking event
For the past couple of years, Dr. Pastor has been part of the American College of Cardiology’s (ACC’s) Diversity and Inclusion LBGTQ+ working group. He helps to raise issues of LGBTQ+ education and awareness. At this year’s ACC conference, he and other committee members wanted to host an LGBTQ+ social event. They wanted to create an experience where LGBTQ+ conference attendees could say, “This is a place where I can meet other people like me.”
In March, at their national conference in New Orleans, it happened. The ACC held an LGBTQ+ networking event with Dr. Stephen Cook, Dr. Matthew Carazo, Dr. Leigh Reardon, and Dr. Pastor spearheading the gathering. “It was the first one ever and drew about 50 attendees,” he says.
Last year Dr. Pastor connected through social media with one of Eko Health’s co-founders, Jason Bellet, who identifies as part of the LGBTQ+ community. Like Pastor, he is outspoken in raising awareness for LGBTQ+ clinicians and families. As a result, Eko Health sponsored the social networking event.
“Honestly, kudos to the ACC. The event seemed to spawn lots of ideas for future projects because now we have residents and fellows on some of our calls. They’re interested in several of our initiatives and have ideas for their own projects,” he says. “Going forward, it seems like it's going to get even bigger and better.”
Using the 3M™ Littmann® CORE Digital Stethoscope to detect congenital heart disease
To celebrate Pride month, Eko Health sent Dr. Pastor 3M™ Littmann® CORE Digital Stethoscope with a rainbow-colored sheen on the chest piece. He recently used it for the first time.
“During my fellowship, my attending physicians would ask, ‘Don't you hear that murmur?’ I would sort of hear it, but not really,” he describes. “I had my hearing tested, and it was fine, but I went through 4 different stethoscopes. I tried the Littmann® CORE last week in clinic ― the volume is a game changer. And I love that it’s rainbow-colored.”
Dr. Pastor says it can be easy to miss subtle clues to a patient’s condition when listening to heart sounds. Some congenital heart diseases, like a bicuspid aortic valve where the aortic heart valve has 2 leaflets instead of the normal 3, can go undiagnosed for years. “They can be devastating if you miss them. A lot of these patients don’t even have a murmur. They just have a very subtle click that you can barely hear,” he notes.
Another benefit of the Littmann® CORE is its recording feature when paired with the Eko App. Dr. Pastor looks forward to using it to train medical students and residents about heart sounds. “I usually tell them to listen where I’m listening. With the Eko App, I can just record what these murmurs sound like and have them listen after the fact.”
Gay doctor and gay patient
For Dr. Pastor, representation is personal and professional. “I’m a queer gay cardiologist. I’m also a gay patient,” he says.
“If you’re a queer human being, you Google what hospitals you’re going to go to, and which doctors you’re going to go to, to make sure you feel safe. It’s important that the LGBTQ+ community realizes that their healthcare is safe for them,” Pastor says.
“I want more LBGTQ+ patients in my panel because I know they’re out there. I know we, as healthcare professionals, have a long way to go to rebuild that relationship with them because there’s a lot of distrust. I’m hopeful that soon, we’ll be able to rebuild that trust. I want patients to get good care because my LGBTQ+ community deserves the highest standard of care, just like everyone else.”
Learn more about how the 3M™ Littman® CORE Digital Stethoscope can enhance your ability to hear heart sounds.