By Linda A. Cronin
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Do you find it difficult or impossible to transfer to the exam table at your doctor’s office? Do you ever need to be lifted by staff? Has the nurse ever skipped weighing you because the scale is inaccessible? Have you been examined while sitting in your wheelchair? Do you find it tough to access the office because of heavy doors, few parking spaces, hidden ramps, or narrow hallways?
For me, the answer to all the above is yes, yes, yes, yes, yes. Time after time, the quality of effective medical care I receive is compromised when I am told, “We can’t transfer you or weigh you,” because of my physical disability. Each time I’m examined in my wheelchair, changes in my physical condition are missed, creating an opportunity for problems to go unnoticed until they develop into a serious condition, like cancer or infection. Why not hang a “Disease welcome” sign around my neck? Remaining seated in a wheelchair makes it impossible for a physician to notice skin breakdown on my behind. Range of motion can’t be checked either.
Accessibility to medical care includes being weighed. A physician needs to know a patient’s accurate weight and any weight loss and/or gain over time. For over 10 years, I’ve used a wheelchair and been treated at a hospital specializing in orthopedics, yet I have never been weighed by a doctor on an accessible scale.
Each time I visit a doctor, whether a primary care physician or a specialist, the exam rooms are difficult to navigate because they’re small and crowded with furniture. Doctors’ offices outside the hospital are even worse with narrow hallways, heavy doors, inaccessible bathrooms, and exam rooms you must back into and then, are left barely able to close the door.
According to the U.S. Census of 2000, people with disabilities are 19.3% of the population aged five and older and not in institutions. That’s nearly one person in five. Half of people over age 65 have some form of disability. Accessible medical equipment doesn’t just benefit people with disabilities, it makes everyone’s life easier-including medical staff no longer have to fear injury from lifting people.
Accessibility problems are solved simply and efficiently if physicians care enough to make the necessary changes. Simple things like replacing inaccessible exam tables with ones that are height-adjustable. Possible solutions are easily found; simply enter the phrase “accessible exam tables” into an Internet search engine. A report compiled by J. Kailes and C.MacDonald from the Center for Disability Issues and the Health Professions, Western University of Health Sciences (www.cdihp.org/products.html) shows accessible exam tables and scales, and the exact guidelines to increase the accessibility of a physician’s office.
The Americans with Disabilities Act (ADA) supports us in our fight for equal access to healthcare. Title II covers health care activities of the state and local government while Title III covers privately operated medical and health care facilities, including doctors’ offices within a private home. The Disabled Access Tax Credit exists for certain expenses incurred in complying with the ADA. In recent years, an increasing number of public and private discrimination suits have made clear where the law stands. A class-action lawsuit, Metzler v. Kaiser Permanente of California, resulted in a major health maintenance organization agreeing to install accessible medical equipment, including wheelchair accessible scales.
But the ADA needs someone to enforce it. I believe it’s our personal responsibility to take care of our health, and to advocate for the most effective, accessible health care. We should point out accessibility problems to a physician when they occur. Make specific suggestions. Give copies of the report by Kailes and MacDonald to the healthcare person who makes decisions. Ask directly, “When will you be getting a height adjustable exam table or a wheelchair accessible scale?” A study of 379 Massachusetts health care providers found 33% made access changes based on patient recommendations for improvement. If gentle requests don’t make the point, it may be necessary to follow through with a complaint with the Department of Justice or a lawsuit.
Equal access to effective health care is our right under the law, and our lives depend on it. Don’t remain silent any longer.
Linda A. Cronin is a freelance writer and desktop publisher who lives in New Jersey.
