Many medical facilities remain difficult to access, while doctors continue to harbor biases, study finds
The 1990 Americans with Disabilities Act and subsequent ADA Amendments Act of 2008 mandated equal access to health care access to people with disabilities. But a new study finds many doctors still either unable or unwilling to provide the same level of care to patients with disabilities as those without.
The authors gathered data for the study by conducting focus groups with primary care doctors in both rural and non-rural practices and with specialists in a variety of areas. Interviewers asked them about the challenges they faced in caring for patients with mobility, hearing, vision, mental health, and intellectual disabilities. The physicians were also asked about their knowledge and application of the ADA.
Participants identified five general barriers to providing care for patients with disabilities. These were:
The authors say their findings highlight the difficulty of ADA enforcement given the discretion doctors have in making clinical decisions. They note that the excuses doctors in the study gave for not providing care all seem plausible, making it nearly impossible to prove intent to discriminate against patients with disabilities.
The researchers say that making health care settings more accessible and establishing disability education standards for doctors will help overcome the problem but won’t address physicians’ own biases. They call for the use of “all available tools”—including education, publicity, lawsuits and policy levers to address the negative consequences of doctors’ doctors’ stigmatizing attiudes towards patients with disabilities.
The study, “’I Am Not The Doctor For You’: Physicians’ Attitudes About Caring For People With Disabilities” appears in the October 2022 issue of Health Affairs.