Medical care and disability

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NHE
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Medical care and disability

Post by NHE »

Many doctors are still befuddled by accommodating people with disability
By Lisa I. Iezzoni Jan. 13, 2022

https://www.statnews.com/2022/01/13/doc ... isability/

Shortly after one of my younger sisters was diagnosed with breast cancer in her early 50s, I scheduled a routine check-up with my new primary care physician. I use a wheelchair because of multiple sclerosis and so I’m typically hypervigilant about accessibility. But I was so relieved to have this new physician, who came highly recommended both for clinical skills and kind demeanor, that I let my guard down and didn’t visit the practice beforehand.

That was a mistake.

The physician’s office was in one of those architectural gems from the early 20th century — a bow-fronted building with large windows and handsome woodwork. At least it had a workable ramped entrance and an old-fashioned but functional elevator.

We began the visit in the doctor’s office. After hearing about my sister’s recent cancer diagnosis, the physician wanted to do a complete breast exam, with me supine on the exam table. But the exam room across the hall was small, and getting me and my wheelchair into the room, dominated by its fixed-height exam table, would be a tight fit. In any case, I could not safely get onto the high table using the room’s small step stool. As the appointment time was running short, the physician did a cursory breast exam with me seated in my wheelchair.

As a researcher studying health care disparities for people with disability, I know this experience was not uncommon. I have interviewed hundreds of people with various disabilities who described their experiences receiving substandard care because of failures to accommodate their disability:

• Pregnant wheelchair users not weighed during prenatal care visits because no accessible weight scale was available — some were told to ask their post office to weigh them on package scales.

• Women not given Pap tests to check for cervical cancer because their clinicians did not get them out of their wheelchairs.

• Clinicians who refused to hire American Sign Language (ASL) interpreters for Deaf patients who requested this accommodation to ensure effective communication, and who instead insisted on writing notes on paper. In one instance, a Deaf woman receiving her first Pap test was not told that a speculum would be inserted and felt she was unexpected and painfully violated; a Deaf man receiving a testicular exam was not informed why and thought he was being sexually assaulted.

Nonetheless, despite what I know about health care for people with disability, when my new primary care physician gave my breast exam short shrift, I felt powerless to object.

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