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18 COMMUNIQU SUMMER 2016 ALUMNI by Pat Grauer As an MSUCOM student Brian Bakofen 05 was known for his energy and advocacy traits that he took with him ve years ago into his career as a lead physician at Fenway Health in Boston. Fenway began in 1971 as a volunteer program with three distinct priority collectives to serve women gay men and the elderly people who lived in their district of Boston. Impacted signicantly by the AIDS crisis in the early 1980s focus largely shifted to caring for patients with AIDS. Since HIVAIDS management has progressed and transformed this illness to a more chronic disease Fenways target patients have expanded to include all people including transgender health chronic care pediatrics behavioral health and obstetrics and gynecology in fact Fenway is one of the largest providers in New England for transgender health and HIV. Hired to do primary care Bakofen quickly moved into a managers role for his oor adding to his practice responsibility as a providers liaison and trainer for information technology committee work the Patient- Centered Medical Home transition team the opioid management team rounding as a hospitalist at Fenways major afliates and providing osteopathic manipulative medicine along with two other DO colleagues. Primary care is very hard but I like it Bakofen said. When I arrived I had no HIV treatment experience whatsoever and in the rst year they made sure I was certied as an HIV specialist its a requirement of employment. In addition some of Fenways providers have completed infectious disease fellowships and others are experts in transgender health. All Fenway primary care providers end up with HIV and transgender health training and patient care through an organizational commitment to education. Says Bakofen We spend a lot of time in education. Bakofen is excited by the research that is conducted at Fenway. We were the rst site in the U.S. for a major study on PreP pre- exposure prophylaxis of HIV he said. We were prescribing PreP earlier than just about anyone and now nationally it is preventing a lot of HIV transmission. Its awesome to walk in the door and think Wow I work in a place where things are happening. He notes that its a testament to the trust patients have for their caregivers that they are willing to participate in clinical research in high numbers. In addition they have a new program in which behavioralists are embedded within each medical area and are available to work with patients immediately at a point of need. What are Bakofens recommendations for treating a diverse patient population Make sure the patients feel welcome and comfortable. Avoid barriers such as restricting gender to male or female leave an option for other Make sure you know your patients preferred names even if theyre different than their legal names. Pronouns are also important but harder to learn. When I started writing her penis hurts was cognitively difcult but not now he said. For gender-uid patients ask what pronouns they want to use most of the time and remember they may not t the binary system most of us use When asking about sexual history be very open and general with your questions Are you sexually active What are your partners like What kinds of sex are you having Dont judge Dont be afraid to learn from the patient. OK I dont know much about that. Could you explain it Or I could look into it. We at Fenway have educational resources knowledge and are not judgmental Bakofen said. It makes a big difference when people walk in the doors and see others like them. To do all this in primary care is very rare but we take care of everything. BRIAN BAKOFEN HITTING HOME RUNS AT FENWAY Brian Bakofen found a home at Fenway Health which has met the needs of Bostons underserved populations for 45 years. 18 COMMUNIQU SUMMER 2016