“I am not the doctor for you”

In a recent survey study published in Health Affairs, physicians attitudes about caring for people with disabilities were examined. In each of the focus groups, several barriers to providing care for people with disabilities were identified and include: physical accommodations; communication accommodations; knowledge, experience, and skills; structural barriers; and attitudes toward people with disabilities. Furthermore, many described discharging people with disabilities from their practices or denying care.

Persons with disabilities have long noted barriers and suboptimal care; however, this was one of the first studies confirming from the providers standpoint what many patients have experienced. Other studies have found data regarding health disparities for those with disabilities and at least on some level, the negative attitudes and biases of physicians are contributing.

It is estimated that approximately 26% of the US population has some type of disability and in many circumstances, they have higher healthcare needs that tend to be complex. Additionally, most clinicians are non-disabled, sometimes referred to as able-bodied, and there is a long-held belief that a “normal” (i.e., non-disabled) body is better or preferred. Thus when there is a non-curable condition, many explicit and implicit biases coupled with ableist views on the persons quality of life will be likely incorporated into treatment decisions, which subsequently lead to the health disparities observed for those who are disabled.

As a disabled healthcare provider, I am beyond disappointed but sadly not surprised with the results of these study. Being partially deaf with low vision, I have long masked my conditions in the work environment. Now that my vision loss has progressed, it is much harder to mask and all of my department colleagues are aware as well as the students and residents I teach. To that end, due to the stigma of disability in healthcare, I walk to work with my white cane and then fold it up at the entrance and walk into my workplace without it despite it being helpful for my mobility and orientation to spaces. Often blindness is associated with an intellectual disability (to be discussed further in the future), but the reality is my vision loss has minimally altered my ability to do my job and minor accommodations have allowed me to continue to serve others through my work.