By Erin Blakemore,
The Americans With Disabilities Act has been in force for more than three decades.
But do doctors understand their legal obligations under the law — and are they doing all they can to accommodate patients with disabilities?
In a word: No.
That’s the message of a study in Health Affairs that points to significant knowledge gaps among the providers — and suggests that nearly three-quarters of outpatient physicians don’t understand how to accommodate their patients’ disabilities.
Under the ADA, all clinics must accommodate their disabled patients’ needs and provide them equal access to their facilities. But when the researchers surveyed 714 physicians practicing family medicine, internal medicine, neurology, obstetrics and gynecology, ophthalmology, orthopedic surgery and rheumatology, they discovered significant gaps in their knowledge of the law.
Over a third of the physicians said they knew little or nothing about the ADA, and 71.2 percent answered questions about required accommodations incorrectly.
The majority of the physicians — 68.4 percent — believed they were at risk for an ADA lawsuit because of problems providing accommodations. Participants who said that a lack of formal training was a barrier to providing care were much more likely to say they are at risk.
The study “raises troubling questions about healthcare quality and equity,” says the paper’s lead author, Lisa I. Iezzoni of the Mongan Institute’s Health Policy Research Center at MGH, in a news release.
The researchers call for more rigorous training in disability and civil rights at all junctures of medical education. In another study using the survey, they found that more than four-fifths of physicians surveyed said that people with disabilities have a worse quality of life than those without disabilities. Those implicit biases, they write, could constitute a “hidden curriculum” that in turn influences trainees — and affects patients.
According to the Centers for Disease Control and Prevention, more than 1 in 4 adults in the United States has some kind of disability — and people with disabilities face significant barriers to health care, with a full third of adults with disabilities lacking a routine health-care provider.
Accommodations for those patients’ needs, the researchers write, are both a “civil right . . . and a moral imperative.”
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