One would think that patients with disabilities would receive the same, if not better, care and attention from doctors than people without disabilities. Sadly, this is a misconception that has left many with disabilities receiving sub-par care. A recent report published in the Annals of Internal Medicine takes a closer look at why disability discrimination tends to result in poorer health and worse outcomes at the doctor’s office.
The Americans with Disabilities Act (ADA) has been in place for nearly 23 years, prohibiting discrimination against people with disabilities. Despite the law, numerous studies have been published in recent years that have proven the disparity between the medical care people with a disability and able-bodied patients receive. One study even showed that women with disabilities are less likely to be properly diagnosed when they have breast cancer. But the question that was left unanswered was Why?
Dr. Tara Lagu, a physician-researcher at the Center for Quality of Care Research at Baystate Medical Center in Springfield, Massachusetts set out to figure out why. She had no external support and no research grants to help her. Instead, with the help of her co-investigators, she created a fictional patient. The patient was a stroke victim, partially paralyzed and weighing roughly 200 pounds. The patient could not get out of a wheelchair without assistance and needed specialized evaluation.
More than 250 doctor’s offices were called. The researchers presented themselves as the doctors that they were and asked for an appointment for the patient. The responses, sadly, were not surprising.
Excuses abounded, and one out of five offices refused to book an appointment, citing everything from non-accessible buildings to lack of trained staff members to assist the patient out of the wheelchair. Some offered explanations that clearly violated the ADA, expressing fear over potential injuries to staff members because of the patient’s weight and disabilities.
Those doctors who agreed to see the patient admitted that they had no equipment for moving the patient safely, nor did they have plans for handling the patients special needs. Others offered to complete the portions of the exams they could and forgo the rest. Less than 10 percent of the 250 offices located in four major cities had the appropriate equipment and staff to handle the patient.
“People assume that just because we are health care providers, we are accessible to patients,” Dr. Lagu said. “But in fact, the vast majority of practices are probably doing things that if I were disabled, I would not want to have done.”
An unfortunate reality–the equipment needed to meet the needs of the fictional patient is costly. For example, a height-adjustable exam table can cost well over $4,000.
There is hope on the horizon for patients with disabilities, though. The new provisions in the Affordable Care Act has a panel of specialists who will discuss specific guidelines and put together a list of recommendations to help address the problems faced by patients with disabilities.
Does disability discrimination exist at your doctor’s office? Share your experience here.