Why Are Doctors Failing to Treat People With Special Needs?

From difficulties securing transportation for medical appointments to encountering inaccessible health care websites, people with various disabilities encounter barriers to basic health care on a regular basis.

Some doctors are only making these disparities worse, recent research suggests.

A focus group study of 22 primary care physicians from across the country revealed five main themes regarding the challenges these physicians reported in caring for people with disabilities:

• Physical accommodations – The physicians’ buildings, exam rooms, and medical equipment may not comply with accessibility laws for patients with disabilities, such as wheelchair users.
• Communication accommodations – Doctors reported that they often rely on the caregiver of a patient with special needs to communicate about their care. None of the physicians participating in the study offer their patients documentation in Braille. Few provide printed communications material in large type for individuals who have low vision.
• Knowledge, experience, and skills – The study participants acknowledged a lack of experience among themselves and their staff in addressing the needs of people with disabilities. Many of the doctors also reported having little familiarity with the Americans with Disabilities Act.
• Structural barriers – The primary care physicians also cited such dynamics as limited time for patient appointments and the burden of paperwork as creating barriers to providing comprehensive care for patients with special needs.
• Attitudes toward people with disabilities – Some doctors, the researchers found, exhibited negative attitudes – even explicit bias – about patients with disabilities. This included the language they used when talking about their patients or describing the needs of these patients as an inconvenience.

While some physicians were aware they could not deny a patient care based on a disability, others “reflected on strategies that would allow them to discharge the patients but minimize risk for lawsuits or other consequences.”

While stressing the need for clinicians and policymakers alike to work on confronting these challenges, the study’s authors also assert that such efforts are still not enough to guarantee that people with disabilities are receiving quality health care.

“Perpetuation of inequitable care for people with disabilities,” they write, “is inconsistent with the mission of medicine and public health.

Amid this research, other scholars have reported findings that people with disabilities have been at far greater risk of dying from COVID-19. For instance, those with intellectual disabilities were six times more likely to die after contracting COVID-19 than other members of the population.

Read more in the research article, titled “‘I Am Not the Doctor for You’: Physicians’ Attitudes About Caring for People With Disabilities.”