Does your physician know enough?

 Does your physician know enough about helping people with disabilities?

 

It has been over 30 years since the Americans With Disabilities Act (ADA) took effect.  Recent research shows that many physicians are still unaware of their obligations under the law.

Well over one-third of doctors surveyed had little to no knowledge of their obligations under the law.  And almost three-fourths had not a clue what a reasonable accommodation is.  These findings come from a study published in the Journal of Health Affairs.

The lead author in the study, Dr. Lisa Iezzoni of the Harvard Medical School, found that even though people with special needs comprise about 25% of the population; she found multiple barriers to effective health care and particularly lack of knowledge about the requirements of ADA.

The ADA bars discrimination against people with disabilities including the delivery of medical services.  Yet, how can a physician deliver appropriate health care if she/he doesn’t know what “appropriate” is under the law.

Iezzoni recommends that people with disabilities quiz the practice before making an appointment. For example, it is not unusual for someone using a wheelchair to find the examination takes place while the person is still seated in the chair rather than be moved to an exam table where a more thorough examination could take place.  ADA requires sign language interpreters for those who are deaf.  The interpreter should be a neutral party so that the views of a friend or family member are not filtered into the responses of the patient.

Additionally, physicians are often asked to verify or advocate for school based services for children with disabilities.  If the physician does not know what accommodations are needed for children with special needs to benefit from an education how can he/she perform this vital function?

Physicians are not blind to the vulnerability this lack of knowledge creates.  In the study, 68% said they felt at risk for a lawsuit for failure to provide adequate care to a person with special needs.

Medical schools are working hard to educate med students about the need to combat racism in health care.  Little to nothing is included in a med school education on how to provide appropriate care to a person with special needs.  

It is unfortunate that this void will be addressed only out of fear of a lawsuit.  The greater risk is the damaging consequences to people with special needs when their medical needs are not appropriately met