| Polio Tips and Techniques
By Dr. Richard L. Bruno
I got a call from a very upset power wheelchair-using patient. She had gone for a mammogram the week before and just got a message that there was a shadow on her left breast and that she needed to come back for another mammogram. The next available appointment: Two months! She believed that the technicians couldn’t get her powerchair close enough to the X-ray machine to get a clear picture because they didn’t take the time to let her remove the powerchair’s joystick. After making a few calls, I got the patient a follow-up mammogram the next day and, sure enough, without the joystick there was no shadow and no cancer.
One year ago I wrote in this space that one area wasn’t addressed by the ADA: Physical access to medical equipment and facilities for people with disabilities. There was nothing in the ADA to make the inside of health care facilities wheelchair accessible. Doorways are too narrow, exam rooms are too small and examination and treatment tables are too high for safe transfers. Mammography machines are made for women who can stand, not women in wheelchairs. And, I have patients who never have had a gynecological exam because they can’t get onto a four-foot high table without the danger and embarrassment of being lifted.
To fill the gap in the ADA, I wrote the New Jersey “Physical Access to Health Care Act,” which recognizes that those with physical disabilities must overcome physical barriers in order to access health care. The Act requires that health care professionals—physicians, podiatrists, acupuncturists, physical therapists, orthotists/prosthetists and dentists—have offices and medical equipment that meet the needs of patients with physical disabilities and are in compliance with the Americans with Disabilities Act.
The Act requires health care professional office accessibility, including parking, the office entrance and interior, toilet facilities and equipment used to examine or treat patients. The Act requires that a health care professional’s office have at least one height-adjustable patient examination table that can be lowered to no more than eighteen inches above the floor to facilitate the transfer of a patient with a mobility impairment. If an office provides imaging services, the Act requires that it have one height-adjustable, wheeled ambulance stretcher, that can be lowered to no more than eighteen inches above the floor, to be used to transfer a patient to and from tables and equipment that is not adjustable in height, such as computerized tomography, magnetic resonance imaging, positron emission tomography and radiation therapy machines.
The Act also requires that hospitals, nursing homes and other residential treatment facilities have at least one examination table suitable for gynecological examinations that can be lowered to eighteen inches above the floor and, if they have radiological or imaging equipment that is not adjustable in height, also have one height-adjustable, wheeled ambulance stretcher.
What happened to the New Jersey “Physical Access to Health Care Act?” It died a silent death.
So, I called Sen. Tom Harkin (D-IA), one of the Senate’s leading disability advocates, to see if he would sponsor a federal “Physical Access to Health Care Act.” His legislative director told me that the senator had just sponsored a bill to “study the specifications required for accessible medical equipment.” I agreed that proper “specifications” for accessible medical equipment, like an accessible mammography machines, were important. But I told him that women who use wheelchairs weren’t getting gynecological exams and that wheelchair users and others with mobility impairments were not getting vital medical getting care for want of a $1,500 ambulance stretcher and that they needed help now. The aide wasn’t interested in another bill. What happened to Sen. Harkin’s “specifications required for accessible medical equipment” bill? It, too, died a silent death.
You know, I do appreciate the ADA. But isn’t it at least as important to have access to an MRI as to see a movie or go to a ball game? Please join the The International Post-Polio Task Force and contact your Congressperson (www.House.gov), Senators (www.Senate.gov), and state legislators and ask them make “Physical Access to Health Care” the law.
Dr. Richard Bruno is Chairperson of the International Post-Polio Task Force and Director of The Post-Polio Institute and International Centre for Post-Polio Education and Research at Englewood (NJ) Hospital and Medical Center.
