BY TARA LAGU: For Complete Post, Click Here…
IWAS A RESIDENT working in an underresourced health clinic when, one afternoon, my triage paper indicated that my next patient needed a Pap smear. I walked into the room and found a woman sitting in a wheelchair.
Although I smiled and tried help her feel welcome, I felt nothing but panic.
During medical school, I had not been trained to care for people with disabilities. Now a resident, I didn’t even know to ask whether the clinic had access to a height-adjustable exam table. What I did know was that, because of my lack of experience and prior training, there was no chance I could perform a Pap smear for this person today. I apologized for the inconvenience and arranged an appointment for the patient at a women’s hospital on a different day and with a different doctor.
When I became a researcher, this experience, and others like it, led me to explore the disparities in care that patients with disabilities face. Through those studies, I have come to strongly believe that these disparities aren’t just a problem for patients who need sign language interpreters or accessible tables – they’re simply some of the most egregious cases of what all patients face in the United States health care system.
In 2013, my research team and I called a random sample of doctors from four U.S. cities, each time posing as a doctor making an appointment for a patient who used a wheelchair. Of the subspecialists we called, 20 percent said they could not accommodate such a patient. Some lacked adequate training or staff or equipment; a few said that their building was simply inaccessible, even though access to health care settings is a requirement of the Americans with Disabilities Act, or ADA.
More recently, we conducted focus groups with physicians to better understand the barriers that exist to caring for people with disabilities. Physicians in our recent study spoke with surprising candor, revealing in some cases profound biases toward people with disabilities. Undark reported on that study in November, which described doctors who reported using excuses in order to avoid treating people with disabilities. Some told prospective patients their caseload was full, or that they didn’t accept their insurance. Others were more straightforward, and simply told patients, “I am not the doctor for you.”
The attitudes and behaviors expressed by doctors in our recent study are inexcusable, unethical, and possibly illegal under the ADA. They also highlight why many patients with disabilities struggle to find doctors who will care for them, and suggest an urgent need to address disparities in health care access and quality.
But these dramatic examples not only provide a window into the U.S. health care system’s failures towards people with disabilities — they also reveal just how broken the system is for all patients.
