Dr. Lisa Iezzoni, a professor of medicine at Harvard, had been hearing complaints about doctors’ attitudes toward caring for people with disabilities for years. Dr. Iezzoni, who has multiple sclerosis and uses a wheelchair herself, decided that the time had come to do a study of what physicians really thought when they encountered a patient with a disability in their own offices.
She developed a research study that put together a representative group of diverse primary-care physicians and specialists from across the U.S., and divided them into three focus groups of 8-10 doctors that met via video conference. Everyone was anonymous, only first names and nicknames were used. The anonymity was vitally important because it allowed the doctors to relax and speak frankly.
The study’s findings, published last month in the journal “Health Affairs,” surprised even one of its authors, “It was so shocking, I almost couldn’t believe it,” said Dr. Tara Lagu, professor of medicine and social science at Northwestern University.
Here are some of the surprising findings:
- Wheelchairs presented multiple problems: patients couldn’t be weighed on office scales, needed exam tables with adjustable heights. Some doctors told patients to go to a supermarket, a grain elevator, a cattle processing plant or a zoo to be weighed—or simply told a new patient that their practice was closed.
- Communication accommodations for patients whose hearing, vision or speech is impaired presented other problems, One doctor hired a sign-language interpreter for a deaf patient. The interpreter’s fee was so high that the doctor lost $30 every time the patient came to see him.
- Patients with disabilities often have complicated health issues, and doctors have a shrinking amount of time to spend with each patient… “Seeing patients at a 15-minute clip is absolutely ridiculous,” one doctor said. “It’s just unreasonable and unacceptable to me.”
- Some physicians have developed techniques to discourage patients with disabilities from trying to make appointments. These range from telling patients that the practice doesn’t accept new patients, to cancelling appointments after discovering a patient is disabled, to explaining “our office is too small for your wheelchair” or ”our machinery isn’t good enough for you,” or just saying outright: ”Maybe you should go somewhere else.”
The authors conclude, “People with disabilities are frequently not accommodated in health care settings, often receive substandard care and, in some cases, are refused care.”
Their study has shined a new light on a widespread, long-suspected problem.
Thea Flaum is President of the Hill Foundation for Families Living with Disabilities.