How Can Doctors Turn Away People With Disabilities?
More than 20 percent of doctors in five major metropolitan areas told people with disabilities — who very likely are more in need of routine medical care than most of us — sorry, please go somewhere else for medical care.
That’s what a recent survey in the Annals of Internal Medicine found: that 22 percent of doctors in five metropolitan areas are turning away individuals with disabilities. The reason is one of basic access: many physicians’ offices do not have accommodations for individuals with physical disabilities.
Under the Americans with Disabilities Act (ADA), doctors are to provide “full and equal access to their health care services and facilities.” Buildings, even those built before the ADA went into effect, must be accessible to individuals with disabilities or practices must provide alternatives. Entry doors should be wide enough for a wheelchair or other equipment and medical exam rooms and other areas must be large enough to accommodate such.
“Access” is about more than just getting into a medical practice. Medical offices are required to have lifts or other equipment to help an individual with a disability get onto an exam table (examining a patient in a wheelchair does not provide as thorough an examination). At least one exam room must have an exam table accessible to an individual with a disability. Adjustable exam tables, patient lifts and training for staff can make it possible to transfer an individual. In addition, under the ADA, physicians cannot refuse to treat someone with disabilities because doing so may take longer.
The Annals of Internal Medicine survey revealed that a significant number of medical practices are not in compliance with these ADA regulations regarding medical care for individuals with disabilities.In the survey, researchers polled 256 randomly selected medical practices in Boston, Dallas, Houston and Portland, Oregon. They contacted the practices to schedule an appointment for a fictitious patient who was said to use a wheelchair and who was unable to transfer her or himself independently from the chair to an exam table.
22 percent of the medical and surgical subspecialists contacted said they could not accommodate a patient with such mobility needs. The reasons for turning away a patient differed, but the one most often cited was an inability to transfer the individual from a wheelchair to an exam table. In addition, a number of practices said their building was inaccessible to individuals with disabilities.
Some doctors are more likely to accommodate a patient with disabilities than others with gynecologists the least likely (44 percent of these practices declined to offer care for a patient with disabilities); only 4 percent of psychiatrists did so.
Too often, individuals with disabilities may end up in emergency rooms for what should be routine problems. A hospital or health clinic may have the accommodations and personnel to assist an individual with a disability, but may be in a location difficult to access. Even more, no one should have to go to only to a hospital for routine medical care.
About 1 in 5 Americans have some kind of disability; all of us will be disabled at some point in our lives and in need of accommodations. Next time you’re at your doctor’s office, you might check to see if it has any of the accommodations for individuals with disabilities specified in the ADA. The results of the Annals of Internal Medicine survey are a wake-up call to changes we need to start making now to ensure the well-being of individuals with disabilities — and ourselves.
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