Suche
Mein Konto
Bias and discriminatory attitudes among physicians can contribute to health disparities among people with disabilities
More than 30 years after the passage of the Americans with Disabilities Act (ADA), people with disabilities report having difficulty accessing health care and often finding that doctors' offices refuse to accommodate them. Now, a new Northwestern Medicine study of national practices reports that doctors may choose to deny care to people with disabilities, and some may use discretionary excuses to strategically dismiss them from their practice. Scientists at Northwestern University Feinberg School of Medicine, in collaboration with colleagues at the University of Massachusetts and Harvard Medical School, conducted focus groups with physicians from a national database...
Bias and discriminatory attitudes among physicians can contribute to health disparities among people with disabilities
More than 30 years after the passage of the Americans with Disabilities Act (ADA), people with disabilities report having difficulty accessing health care and often finding that doctors' offices refuse to accommodate them. Now, a new Northwestern Medicine study of national practices reports that doctors may choose to deny care to people with disabilities, and some may use discretionary excuses to strategically dismiss them from their practice.
Scientists at Northwestern University Feinberg School of Medicine, in collaboration with colleagues at the University of Massachusetts and Harvard Medical School, conducted focus groups with physicians from a national database. Doctors who participated in these groups expressed bias against people with disabilities, and a significant number of participants reported making strategic decisions to deny care to people with disabilities, the study found. This includes statements such as “I don’t take new patients,” “I don’t take your insurance,” or telling patients that they need specialized care and therefore “I’m not the doctor for you.”
The study will be published Oct. 3 in the October issue of the journal Health Affairs.
“Our work suggests that biases and discriminatory attitudes among physicians may contribute to the health disparities experienced by people with disabilities,” said corresponding study author Tara Lagu, director of the Center for Health Services and Outcomes Research at the Institute of Public Health and Medicine at Feinberg and professor of hospital medicine and medical social sciences. “We must address the attitudes and behaviors that perpetuate unequal access for our most vulnerable patients.”
Additionally, physicians in the study described a lack of knowledge about how to provide accommodations for people with disabilities, and some expressed opposition to the ADA, saying the legislation "works against physicians."
The ADA is an important promoter of autonomy and independence for people with disabilities. Physicians’ attitudes toward the ADA were disturbing and disappointing.”
Tara Lagu, corresponding study author
The ADA requires all physicians to provide people with disabilities “full and equal access to their health care services and facilities.” This includes the accessibility of buildings, e.g. B. Creating spaces designed to be user-friendly for everyone, including people who use wheelchairs, canes and mobility scooters; Assist in transferring patients from chair to examination table; and providing sign language interpreters and other accommodations. Previous studies have reported that people with disabilities have difficulty getting appointments with doctors and are known to receive less preventative care than their non-disabled counterparts.
“Meaningful improvements in access to quality care for people with disabilities require a multi-pronged approach and should include changes in medical education, efforts to increase the availability of accessible devices, and changes in our approach to physician reimbursement,” said co-author Carol Haywood, research assistant professor of medical social sciences at Feinberg. “At Northwestern, we work to drive change through research and also through advocacy and improvement efforts such as the Disability Advocacy Coalition in Medicine, patient safety and quality efforts at Northwestern Memorial Healthcare, and the NM Champion Network Disability Chapter.”
This study follows a 2012 paper by Lagu in which she attempted to make an appointment for a (fictitious) patient who used a wheelchair. Of 256 practices surveyed in the 2012 study, 56 (22%) reported they were unable to accept the patient. Of the remainder, more than half planned to transfer the patient using methods considered unsafe. Recently, Lagu and Dr. Lisa Iezzoni, professor of medicine at Harvard Medical School, results of a national survey of physicians: Only 56% said they welcome patients with disabilities into their practice; 36% said they knew “little or nothing” about the ADA; and only 41% were confident that they could provide similar quality care to patients with disabilities as those without disabilities.
Funding for the new study, “I'm Not the Doctor for You: Physician Bias Contributes to Health Care Disparities for People with Disabilities,” was provided by the National Institute of Health's Eunice Kennedy Shriver National Institute of Child Health and Human Development (grant number 5R01HD091211).
Source:
Reference:
Lagu, T., et al. (2022) I'm not the doctor for you: Physician bias contributes to disparities in health care for people with disabilities. Health Matters. doi.org/10.1377/hlthaff.2022.00475.
.