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For many disabled patients, doctors are often not available

Unnecessary Obstacles —

Some physicians avoid patients with disabilities, and barriers to routine care abound.

Emma Yasinski, Undark Magazine – 11:16 AM UTC, November 13, 2022

For many disabled patients, the doctor is often not inFor many disabled patients, the doctor is often not in

Ben Salentine, Associate Medical Director, Health Sciences Management, University of Illinois Hospitals and Health Sciences System, weighed less than ten years . His doctors were “just guessing” at his weight, he said, because they didn’t have wheelchair-friendly scales. He’s not alone. Many people with disabilities describe the challenges of finding doctors who are ready to care for them. “You’d think healthcare settings would be the easiest place to get to, but that’s not the case,” said Angel Miles, a rehabilitation program specialist with the Community Living Administration, part of the U.S. Department of Health and Human Services. Not only do clinics often lack the necessary equipment— Examples include scales that can accommodate people in wheelchairs — but according to a paper published in October, at least some doctors actively avoid disability with excuses such as “I don’t take new patients” or “You need a specialist” Patient Health Affairs Division 2022.

work which was analyzed with 22 The focus group discussions with doctors added context to a larger study published in February 2021, also in Health Affairs, which showed that only 56% of doctors strongly welcome disabled patients into their practice. Less than half were confident or very confident they could provide the same quality of care to people with disabilities as other patients. The studies add to a larger body of research showing that quality care is often difficult for patients with a variety of conditions that doctors may consider more difficult to treat. The Americans with Disabilities Act (ADA) of 1990 theoretically protects one in four Americans with disabilities from discrimination in public and private medical practice, but enforcing it is a challenge.

Assistant Professor, Department of Occupational Therapy, Rush University Laura VanPuymbrouck said the 2021 survey was “groundbreaking. It was the cracks that broke the dam a little bit.” Now, researchers hope the Joint Council of Medical Schools, Payers and Hospital Accrediting Organizations will push health care providers toward more equitable care Serve. Information about health care for people with disabilities is limited and partially The reason is insufficient data, according to Tara Lagu, the 2021 and 2022 papers and director of the Center for Health Services and Outcomes Research at Northwestern University’s Feinberg School of Medicine Institute for Public Health and Medicine. The few studies that have been done show that people with disabilities receive less preventive care and have worse outcomes than non-disabled people. About ten years ago, Lagu was having a The patient, who was partially paralyzed and using a wheelchair, was discharged. The patient’s discharge notes repeatedly suggested an appointment with a specialist, which did not happen. Ragu asked why. Eventually, the patient’s adult daughter told Raghu that she could not find a specialist who could see the wheelchair-bound patient. Miraculously, Lagu starts calling. “I couldn’t find a doctor within 100 miles of her home who would see her unless she came in an ambulance and was moved to an examination table by EMS,” she said, “which would cost her family over $1,000.” pockets of dollars.” In recent years, studies have shows that even when disabled patients can see a doctor, their doctors’ biases about conditions such as obesity, intellectual disability and substance use disorders can have a profound impact on the care they receive. A doctor may assume that a person’s symptoms are caused by obesity and tell them to lose weight before considering testing. For a patient, this means The diagnosis of lung cancer was severely delayed. Patients with limited mobility or intellectual disabilities were considered unmarried, so their providers skipped any discussion of sexual health. People in wheelchairs may not be able to be weighed, and even if they are pregnant, tracking weight is especially important at this time, as gaining too little or too much weight can put the baby at risk of developmental delays or the mother’s complications during delivery Risk. These questions are from Lisa Iezzoni As we all know, he is a health policy researcher at Massachusetts General Hospital and a professor of medicine at Harvard Medical School. Iezzoni, who has interviewed about 300 people with disabilities over the past 25 years to study their health care experiences and outcomes, realized that “every person with a disability tells me that their doctors disrespect them and have false assumptions about health.” They, or they didn’t know anything about how to provide care.” In 2016, she decided it was time to talk to a doctor. Once the NIH funded the work, she and Lagu recruited 714 physicians to participate in the survey, which they published in Health Affairs in 2021.

Not only many doctors report feeling unable to properly Caring for people with disabilities, and the overwhelming misconception that these patients have a poorer quality of life, can lead to fewer treatment options being offered.

In that study, Iezzoni’s team Three focus group discussions with 22 anonymous physicians were recorded. While the open-ended discussion was not included in the original publication, Ragu said she was “absolutely appalled” by some of the comments. While some physicians in the focus group welcomed the idea of ​​additional education to help them better care for patients with disabilities, others said they were overburdened and that the 15 minutes often allotted for office visits was not enough to provide patients with proper care. Still others “began to describe how they felt these patients were a burden, that they would take disabled patients out of their practice,” she said. “We have to write it down.”

The American Medical Association, the largest professional organization representing physicians, declined Undark’s request for an interview and would not comment on the two Health Matters studies. Asked about the organization’s policy on caring for patients with disabilities, one representative pointed to the AMA’s strategic plan, which includes a commitment to equity.

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