A new study from Health Affairs published January 4, 2022, finds that many physicians have little to no knowledge about accommodation obligations to patients with disabilities as outlined in the Americans with Disabilities Act (ADA) of 1990. The new research asserts that in this vacuum of knowledge, people with disabilities are receiving disparate healthcare services and that the disparities will continue until physicians become more educated on their ADA obligations and attitudes toward treating patients with disabilities shift.
Health Affairs surveyed 714 physicians in outpatient practices throughout the country for their analysis. Some important findings from the study:
- 36% of physicians surveyed reported knowing little to nothing about their legal responsibilities under the ADA
- 71% of surveyed physicians answered incorrectly regarding who determines reasonable accommodations for patients with disabilities
- 21% of surveyed physicians did not correctly identify who pays for these accommodations
- 68% of surveyed physicians felt that they were at risk for ADA lawsuits
Additionally, the research indicated that physicians who felt that lack of formal education or training was a barrier to treating patients with disabilities were more likely to report little or no knowledge of their responsibilities under the ADA and were more likely to believe that they were at risk for an ADA lawsuit.
The researchers behind the new study point out that people with disabilities can face barriers to treatment, unable to access basic services like a yearly exam due to no accommodations being made to measure weight or provide appropriate communication for patients with visual and hearing disabilities. This is in addition to incidences of patients with mobility issues being examined in wheelchairs instead of being transferred to an examination table which can result in substandard care and often delayed diagnoses. In order to close the gap on these healthcare disparities, researchers insist that physicians must receive education on how to make healthcare more accessible and accommodating, beginning in medical school. According to Eric Campbell, a survey scientist at the University of Colorado and a senior researcher behind the study:
"Medical schools are currently training students about combating racism, and there should also be training in combating discrimination against people with disability, also known as 'ableism.’ Every practicing physician can expect to see increasing numbers of people with disability, and they need to know how to accommodate them.”
The call for re-education in the medical community regarding accessibility is in essence a call for physicians to begin to change their way of thinking about patients with disabilities, the accommodations necessary to treat them properly, and the level of responsibility physicians take on in providing those accommodations. And another new study suggests that attitudes within society and culture about people with disabilities are progressing at much slower rates than attitudes toward other non-majority groups. The Harvard Gazette reports on findings from Dr. Tessa Charlesworth, a researcher in the Department of Psychology at the university whose work focuses on implicit bias. Dr. Charlesworth’s most recent research finds that implicit bias within culture and society toward people with disabilities has not shifted in the past 14 years and that it could take more than 200 years for implicit bias against people with disabilities to reach neutrality, or zero bias.
Charlesworth’s research shows that attitudes during the research period have progressed significantly on gender, gender and sexual identity, and race, but that attitudes toward people with disabilities are at a standstill. She attributes the difference to social movements like #MeToo and Black Lives Matter and their success in buoying those groups.
“My new research tells us that these are the kinds of social events that are prompting transformation not only in our explicit conscious values but also in that cognitive monster of implicit bias,” Charlesworth says, asserting her belief that it will take a similar movement of national reckoning to spark change in society’s collective consciousness regarding implicit biases about disabilities.
Undoubtedly the implicit bias Charlesworth describes exists within the medical community and is in part responsible for the inertia exhibited by some physicians when it comes to proactively providing proper accommodations to patients with disabilities. While the disabled community awaits a national reckoning akin to the #MeToo and Black Lives Matter movements, here’s hoping that improved education within the medical community on ADA requirements and basic best practices for accommodating patients with disabilities serves to end the disparities in quality of care.