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Most physicians express explicit bias towards people with disabilities, new study reveals!

People with disabilities People with disabilities
People with disabilities People with disabilities

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In healthcare settings, people with disabilities get substandard treatment, are not accommodated commonly, and are denied care in some situations.

A study published in "Health Affairs" depicted that the discrepancies in medical care received by individuals with disabilities are perpetuated in part by physicians' prejudice and general reluctance to treat them. Structural, communication, knowledge, physical, and attitudinal impediments to care for people with disabilities were identified. Exploring the attitudes of community primary care doctors and specialists towards treating patients with disabilities was the focus of the study.

Three videoconferences with focus groups were held: (A) With primary care doctors who don't practice in rural areas, (B) With doctors from selected specialities (ophthalmology, orthopedics, gynecology/obstetrics, neurology, and rheumatology), and (C) With primary care doctors who practice in rural areas. For each focus group, 8-10 physicians were chosen from a professional social networking website for doctors called Sermo.

On the basis of literature reviews and prior studies of health care and persons with disabilities, development and testing of a semistructured interview guide was done. Real-time video feeds of every member in the focus groups, incorporating the moderator, were displayed on the screen simultaneously, along with the individual's nicknames or first names. For analysis, recording and transcribing of the focus groups were done. The qualitative data management and analysis software QRS NVivo 12 Pro was used to import the transcripts.

Focus-group responses revealed various challenges in offering care for disabled people, including communication accommodations; structural impediments, knowledge, skills and experience; physical accommodations; and attitudes toward disabled individuals. Every participant mentioned the existence of physical obstacles, such as inaccessible facilities and tools, that prevent the provision of healthcare to those with disabilities. Participants talked about several methods for interacting with individuals with hearing or vision impairments, those who have intellectual challenges, or are suffering from mental illness. 

Only a handful of the participants supplied print materials in large type, and none of the participants could offer patients written information in Braille.  Participants also explained both financial and time-linked challenges of accommodating communication requirements. The lack of knowledge, experience, and skills among doctors and clinic personnel regarding the treatment of persons with disabilities was noticed by doctors in each of the three groups.

The majority of clinicians did not explicitly state that they felt obligated to offer accommodations when patients arrived with their own assistance. Time constraints made it cumbersome for doctors to coordinate care with families of persons with disabilities, specifically when those families lived far away or couldn't make it to appointments. Concerns about scheduling and the capacity to record the requirement for accommodations in the electronic health record were also expressed by doctors. Physicians also talked about the electronic health record's difficulties in recording visitors' accommodation requirements.

Few subjects in all three groups displayed unfavorable attitudes toward individuals with disabilities and frequently employed ableist or outdated terminology (such as "mentally retarded"). Some participants described trying to discharge persons with disabilities from their practices or refusing to provide them with care; the reasons given for these refusals varied. Most doctors suggested that it was quite troublesome to offer accommodations for those who had disabilities.

Hence, individuals with disabilities face barriers when trying to gain access to medical care facilities. Medical education and training must be improved in order to better prepare doctors to manage patients with impairments. Improving access to health care for disabled individuals will need raising the availability of appropriate equipment and the accessibility of space, enhancing clinician's education on the care of disabled persons, and reducing structural barriers in the health care delivery system.

Source:

Health Affairs

Article:

‘I Am Not The Doctor For You’: Physicians’ Attitudes About Caring For People With Disabilities

Authors:

Tara Lagu et al.

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