Knowledge Of Practicing Physicians About Their Legal Obligations When Caring For Patients With Disability

Abstract

Disability civil rights laws require equitable treatment of the approximately sixty-one million Americans with disability. However, federal reports and numerous research studies indicate that this diverse and growing population often experiences health care disparities. To examine one possible contributing factor, we interviewed practicing physicians to explore their knowledge of their obligations to accommodate patients with disability under federal civil rights law. Interviewees reported having had little formal training about, and demonstrated superficial or incorrect understanding of, their obligations in three potentially problematic areas: deciding which accommodations their practices should implement, refusing patients with disability, and holding patients accountable for costs of accommodations. The fact that practicing physicians might not fully understand their legal responsibilities when caring for people with disability may contribute to persisting inequity in their care, and it suggests that further education in the Americans with Disabilities Act and other disability civil rights laws may be warranted.Healthy People 2010-the 2000 decennial federal review of national public health priorities 1 -introduced people with disability as a subpopulation whose members experienced systematic inequities in their health care. Subsequent federal reports and growing numbers of academic research studies have confirmed frequent disparities in care for people with disability. [2][3][4][5] The Americans with Disabilities Act (ADA) of 1990 protects the civil rights of people with disability, a population estimated at roughly fifty-seven million Americans as of 2010. 6 The number of Americans with disability has grown to an estimated sixty-one

Comparison of Access to Primary Care Medical and Dental Appointments Between Simulated Patients Who Were Deaf and Patients Who Could Hear

“…Simulated patients who were deaf at times received direction from clinic staff to bring a family member or friend to interpret for their appointment, which, unless there is an imminent threat to safety or welfare, does not comply with the Americans with Disabilities Act. 26 Although it has been demonstrated that health care professionals vary in their understanding of their legal responsibilities to patients with disabilities, 27 clinic staff may have engaged in explicit gatekeeping or discriminatory treatment of the SPs who were deaf. The VRS interpreters do not follow a scripted greeting, and some interpreters may have informed staff that a person who was deaf was calling or the staff person was able to surmise this based on background noise present during the call, since most VRS calls are made from a call center and present differently.…”

People With Disabilities in COVID-19: Fixing Our Priorities

“…Contrary to best practices that require the provision of reliable preventative and treatment advice, accessible information about COVID-19 (e.g., Braille, plain language, American Sign Language) has been neither immediately nor consistently available. Whether medical clinics and hospitals have adopted policies to assure accessibility of services and reasonable accommodations is unknown, but doubtful: Many health care facilities fail to provide such measures during regular times, due in part to clinicians' lack of knowledge and insufficient training in the needs and rights of people with disabilities (Agaronnik et al 2019;Sabatello 2019). These systemic deficiencies are further compounded for persons with disability who reside in congregate care settings.…”

Issue Brief

“…Many health care providers do not understand the requirements placed on them by the ADA and/or other communication access laws. 13 Health care providers report having little or no training on ADA requirements and demonstrate a failure to understand the basic tenets of disability civil rights law. 13…”