People in the disability community often face obstacles in obtaining appropriate health care.
The Center for Disease Control defines these barriers, called programmatic barriers, as barriers that “limit the effective delivery of a public health or healthcare program for people with different types of impairments”. Examples of these obstacles are inconvenient scheduling, lack of accessible equipment, insufficient time for examinations and procedures, and lack of communication with patients (CDC). This makes healthcare, a necessity for all beings, not accessible to people with disabilities.
Health equity for nondisabled people is essential, especially because the quality of care has been “associated with worse physical health and greater burden of chronic disease for people with disabilities compared to their nondisabled peers” (Lagu 2022). In other words, people with disabilities diagnosed with chronic diseases especially need quality healthcare, and the lack of poor quality of it results in a decrease in their overall health.
A new study was recently published in October 2022. This study analyzed barriers in the healthcare system for people with disabilities. The researchers did this by videoconferencing with three focus groups of various healthcare settings, where they asked each group questions about care for people with specific types of disabilities. The anonymity of the study might have caused the participants to speak more honestly about their feelings and experiences with patients with disabilities. The results, including both verbal and nonverbal responses such as head nods and facial expressions, were recorded and analyzed in data management and analysis software.
The results were shocking: for physical accommodations, some doctors outright stated that their buildings were not accessible, especially doctors in rural areas. “Access to transfer equipment (for example, a Hoyer lift) or accessible weight scales was rare across the groups” (Lagu 2022). If there were no weight accommodations at facilities, patients were sent to a supermarket or zoo. Humans should never be treated inhumanely in this manner, with or without a disability.
For communication accommodations, written materials in braille were not available to any of the groups. For the most part, caregivers were the main source of information for patients with communication issues, meaning that health facilities depended on other resources. Patients also had to provide any communication technology themselves.
Furthermore, Physicians themselves noted their lack of knowledge, skills, and experience about care for people with disabilities. The short time of physician care contributed to a decrease in its quality. Physicians also used outdated terms when referring to people with disabilities and showed a lack of motivation to care for and support them. Physicians mentioned that a strategy they used to discharge patients with disabilities without legality issues was to act as if they couldn’t accept more patients.
The data from this study clearly shows that physicians show a great deal of negative bias toward people with disabilities. This directly contradicts the core purpose of health and medicine: to help all people, no matter their differences. To combat this bias, medical education should adapt to better prepare physicians to treat patients with disabilities.
Sources:
https://www.healthaffairs.org/doi/10.1377/hlthaff.2022.00475
https://www.cdc.gov/ncbddd/disabilityandhealth/disability-barriers.html