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Inaccessible Doctor’s
Offices? Sometimes Yes, sometimes No
By Ben
Mattlin
No matter your disability, one place you
might feel you don’t have to worry about access is the doctor’s office. Unfortunately, studies show that’s
not always the case.
For example, a 2006 nationwide survey
found that three-quarters of people with disabilities have at least a moderate degree of difficulty using examination tables.
The tables are often too high, too narrow, too hard (or otherwise uncomfortable), if not impossible to get up onto. Some respondents
complained about a shortage of hand-holds or grab bars to assist with transfers. Many women found the stirrups difficult to
use.
Additionally, more than two-thirds of those surveyed reported significant problems with medical-imaging
equipment such as x-ray, MRI, mammography and bone-density machines.
Even low-tech procedures such as getting
weighed pose significant physical difficulty for more than half of patients with disabilities.
The survey was
published by a consortium that included the Western University of Health Sciences’ Center for Disability Issues and
the Health Professions (CDIFP) in Pomona, California, and Houston’s Independent Living Research Utilization (ILRU).
Inherent Dangers
June Isaacson Kailes,
associate director of CDIFP and an independent disability policy consultant, was one of the authors of the report. She has
cerebral palsy, gets around mostly in a power scooter, and has enough difficulty with her balance and coordination to find
most doctors’ exam tables—especially those lacking grab bars—impossible to use. That’s not only unfortunate,
she maintains; it’s illegal and could also be dangerous. Even the most competent doctors, says Kailes, “are missing
half the body if they only look at patients who are sitting in a chair.”
All this is nothing new. Kailes’
survey follows other work, notably Medical Instrumentation Accessibility and Usability Considerations, an overview edited
by Jack M. Winters and Molly Follette Story (CRC Press, 2007) and The Surgeon General’s Call to Action to Improve the
Health and Wellness of Persons with Disabilities, from the U.S. Department of Health and Human Services.
Legal Action
However, the problem of
inaccessible medical equipment became a legal issue with passage of the ADA 1990. This landmark civil rights law plainly states
that a physician’s office is no different from a restaurant, laundromat, bakery or other public accommodation in terms
of its obligation to provide equal access for people with disabilities. This applies not only to external features such as
the width of doorways but also to all equipment used to diagnose or treat patients. “People talk about suing inaccessible
movie theaters or stores, but they never think about their doctors’ offices,” observes Kailes.
Some, however, do take action. David Geffen,
a disabilitycivil-rights attorney in Los Angeles, filed a suit last year against a medical imaging center in southern California.
The center, the suit alleges, had no height-adjustable exam table or lift, and refused to either assist or refer Geffen’s
quadriplegic client elsewhere, as required by law. “He was unable to transfer himself from his wheelchair onto the ultrasound
table due to the table’s height,” reports Geffen, and the staff denied him any necessary help. In fact, as a matter
of policy, they flatly declined to offer any solutions at all, a clear violation of federal and state accessibility codes,
Geffen maintains. Public facilities, he points out, are required not just to remove barriers but to “avoid policies,
practices and procedures that discriminate against disabled persons.”
As a result of the lawsuit, the
imaging center changed its policies, retrained its staff and made appropriate accommodations in its facilities.
Complacency
Many people with disabilities
have grown used to working around the system that they may not notice when their civil rights are being violated. “I
need to use a Hoyer hoist [to get up on the examination table], and I must take it with me,” says Mary Martz, an art
education consultant at the Los Angeles County Museum of Art. Martz, who has post-polio syndrome and uses a wheelchair, brings
a strong family member or personal-care assistant to every medical appointment. Still, she never gets weighed. “The
medical staff does not want to help because of liability issues,” she states.
Ironically, not helping makes the staff
more liable to litigation, as well as continuing an unresolved problem. In fact, advocates say quiet acceptance might
be the worst problem of all. Do people with disabilities actually deprive themselves of complete medical care out of sheer
exhaustion from fighting the system?
Kailes says hopeless complacency is so common she calls it the “Four
F experience: frustration, fatigue, fear, and failure. For some people, the effort of seeking health care is just too exhausting
and/or degrading,” says Kailes.
As a result, people may postpone or avoid medical attention, which can
exacerbate undiagnosed problems and even cost lives. “These barriers diminish opportunities for longer, healthier, productive
lives for people with disabilities.”
Some Signs of Improvement
A random sample,
however, uncovers a mix of opinions and experiences, but scant complaints. Nadia Powers praises the “wonderful, attentive
staff” at Cedars-Sinai Medical Center in Los Angeles. Powers always has an assistant with her but rarely needs help
during medical visits. “Everything is there for me,” she says. “The nurses or staff members always assist
me.”
Ben Rockwell, a wheelchair-user in Long Beach, California, is also satisfied. His primary physician
is able to do a full exam while Rockwell remains in his wheelchair. “He finds a way, and is able to do even the prostate
exam and everything else,” says Rockwell, who has multiple disabilities, including post-polio. Rockwell has even had
x-rays at Long Beach Memorial Medical Center without getting out of his wheelchair. “I know they have adjustable-height
examination tables there, but they were able to do everything with me in my chair, which I felt was a very reasonable accommodation,”
he says.
A similar sentiment is echoed by Arnie Pike, of Placentia, California. Pike gets examined in his wheelchair
and finds the medical staff helpful when it comes to getting him onto the scale or exam table. Nevertheless, Pike finds the
doorways and restrooms at his physician’s office too small to accommodate his wheelchair.
Models of Accessibility
One facility
that stands out for its high degree of accessibility is Rancho Los Amigos National Rehabilitation Center, in Downey, California,
just south of Los Angeles. Hugh Hallenberg goes there quarterly to check his weight. For other examinations, he’s examined
elsewhere in his wheelchair. “What’s the point of complaining?” he asks, adding that he once did complain,
and when his complaints went unanswered he ended up changing physicians. Hallenberg has cerebral palsy and uses a motorized
wheelchair.
Ruthee Goldkorn of Moreno Valley, California, sued Riverside Medical Clinic for inaccessibility several
years ago. She won her case, but reports that enforcement has been lax. Among her ongoing grievances: the mammography machine
is technically accessible, in that it is height-adjustable, but the room it’s in is too small to accommodate a wheelchair.
The radiology staff is “rude about even considering alternative methods for those who can’t stand,” she
says. And the counters are too high for a person in a wheelchair to check-in. “Patients with a disability are not treated
with the same respect as other patients,” contends Goldkorn a wheelchair-user. “This is a huge problem everywhere.”
Where to Go for Help
If you’re
facing accessibility barriers in your doctor’s office or other medical facility, you can discuss ways to do things differently.
If an individual doctor or practitioner isn’t receptive, bring your issue up with the facility’s office manager,
patient representative or, if it’s a large clinic or hospital, ADA compliance officer. See if you can brainstorm together
to arrive at solutions.
There are also catalogs of accessible medical equipment your health providers can consider
purchasing. They may be expensive, but they could help avoid a costly lawsuit or even save a life.
And good luck!
You might have a battle ahead of you, but it’s well worth the fight.
