Ben Salentine, associate director of health sciences managed care at the University of Illinois Hospital and Health Sciences System, hasn’t been weighed in more than a decade. His doctors “just kind of guess,” his weight, he said, because they don’t have a wheelchair-accessible scale.
He’s far from alone. Many people with disabilities describe challenges in finding physicians prepared to care for them. “You would assume that medical spaces would be the most accessible places there are, and they're not,” said Angel Miles, a rehabilitation program specialist with the Administration for Community Living, part of the US Department of Health and Human Services.
Not only do clinics often lack the necessary equipment—such as scales that can accommodate people who use wheelchairs—but at least some physicians actively avoid patients with disabilities, using excuses such as “I’m not taking new patients,” or “you need a specialist,” according to a paper in the October 2022 issue of Health Affairs.
The work, which analyzed focus group discussions with 22 physicians, adds context to a larger study published February 2021, also in Health Affairs, that showed only 56 percent of doctors strongly welcomed patients with disabilities into their practice. Less than half were confident or very confident that they could provide the same quality of care to people with disabilities as they could to other patients. The studies add to a larger body of research suggesting that patients with a variety of conditions that doctors may deem more difficult to treat often struggle to find quality care. The Americans with Disabilities Act of 1990, or ADA, theoretically protects the 1 in 4 adults in the United States with a disability from discrimination in public and private medical practice, but enforcing it is a challenge.
Laura VanPuymbrouck, an assistant professor in the department of occupational therapy at Rush University, said the 2021 survey was “groundbreaking. It was the crack that broke the dam a little bit.” Now, researchers are hoping that medical schools, payers, and the group that accredits hospitals, the Joint Commission, will push health care providers for more equitable care.