Physicians’ Perceptions Of People With Disability And Their Health Care

Demonstrating the vital role of physiatry throughout the health care continuum: Lessons learned from impacts of the COVID‐19 pandemic on the disability community

“…Though people with disabilities currently represent an estimated 26% of the U.S. adult population, or one in four adult Americans, there continues to be ableism—discrimination and social prejudice against people with disabilities based on the beliefs that typical abilities are superior, disabled people require “fixing,” and people are defined by their disability 5 . In fact, a survey published in February 2021 of physicians' perceptions of people with disability showed that 82.4% reported that people with significant disability have worse quality of life than nondisabled people 6 . In society more broadly, implicit biases regarding disability are higher than implicit biases for race, skin tone, and sexuality 7 .…”

“…5 In fact, a survey published in February 2021 of physicians' perceptions of people with disability showed that 82.4% reported that people with significant disability have worse quality of life than nondisabled people. 6 In society more broadly, implicit biases regarding disability are higher than implicit biases for race, skin tone, and sexuality. 7 The types of implicit bias that have decreased the most over time are the biases that have received more societal attention; implicit biases about disability have not changed over time.…”

Inestimable Harms:

“…Well-conceived policies, however, and well-crafted guidelines, are essential tools in preventing discriminatory treatment based on deeply rooted biases and assumptions about disabled lives. Without guidelines and accountability, individual discretion drives treatment decisions, a hazardous route when 82.4 percent of US physicians report that “people with significant disability have worse quality of life than nondisabled people,” and only 40.7 percent feel “very confident about their ability to provide the same quality of care to patients with disability.” 37 Care decisions made behind closed doors may well be disproportionately adverse to people with disabilities (and to older and heavier adults, and people of color), 38 and people with disabilities “have expressed concern that crisis triage protocols have not adequately prioritized their lives when determining how to allocate access to life-saving health care resources.” 39 It is of significant concern, then, that twenty-two states have no crisis standards of care publicly available, or simply no plan in existence at all. 40 …”

Health care for people with disabilities: Need for systemic change

“…A recent publication by Iezzoni et al 1 titled Physicians' Perceptions of People with Disability and Their Health Care revealed physicians' systemic misperceptions of quality of life of people with disabilities and poor confidence in their ability to understand and accommodate the unique needs of people with disabilities in their practices, which was associated with their reluctance to accept such patients in their practices. In this perspective piece, we highlight and breakdown some of the key issues identified in Iezzoni et al's article, discuss American Academy of Physical Medicine & Rehabilitation (AAPM&R) led initiatives that have advocated for much needed changes to curricula and disability-related competencies, and create a call to action that will ultimately lead to an envisioned future where all people with disabilities have access to high-quality health care free of prejudice and discrimination.…”

“…3,5 For example, a third of working-age adults with disabilities do not have a usual health care provider and a third have unmet health care needs. 2 As Iezzoni et al highlight, physicians are not exempt from deficit-based perspectives about people with disabilities, 1 and many physicians misperceive quality of life for people with disabilities. 1,[6][7][8] As a result, when physicians make medical judgments and care decisions, the results can be a deadly form of discrimination.…”