Although federal civil rights laws prohibiting discrimination against individuals with disabilities have been on the books for fifty years, patients with disabilities continue to suffer worse health outcomes and unequal treatment when visiting their healthcare providers, according to a new academic study published in the journal Health Affairs. Part of the problem is that health care providers do not systematically collect disability-related information, thereby undermining their ability to provide effective care. But many doctors do not address their patients’ needs even when they know about those needs, the study suggests.
“The enduring health and health care disparities disadvantaging Americans with disabilities are discouraging, given the nearly half-century of civil rights laws intended to achieve equity for disabled people,” the study states, in reference to laws like the Americans with Disabilities Act (ADA) and Section 504 of the Rehabilitation Act, both of which prohibit discrimination against individuals with disabilities in the doctor’s office and other settings.
These health and health care disparities have many root causes. According to the study, one basic problem is a lack of information. The electronic health records used by doctors to organize patient information like age and health history “do not consistently capture disability status, despite the need for this information to support clinical care and facilitate the timely provision of reasonable accommodations during health care encounters,” the study notes.
But even if doctors know about their patients’ disabilities, barriers to equal care persist. Many doctors do not know about their responsibilities under the ADA and do not provide the auxiliary aids and services that patients with disabilities need (and which are required by federal law) in order to effectively communicate with their caregivers. For instance, some blind patients may require that written healthcare information be provided in large print. But as many as half of doctors rarely or never provide large print to blind patients who need it, the study concludes (based on a 2019–20 U.S. national survey). Clinicians need more training about their legal obligations under laws like the ADA and Section 504 and also on strategies and accommodations to address communication barriers, the study adds.
The academic study published this month in Health Affairs, titled “Have Almost Fifty Years of Disability Civil Rights Laws Achieved Equitable Care?” expands upon many of the themes outlined in the National Council on Disability’s (NCD’s) 2022 Health Equity Framework for People with Disabilities, which was last updated in August 2022.
In that framework document, the NCD also stressed that improving the collection of disability-related data is essential. “Health care organizations must . . . systematically collect and record patients’ disability status and needed accommodations within electronic health records (EHR) as a means of planning and providing informed, quality health care,” it noted. The NCD also noted that doctors “often lack the knowledge, experience, and skills to distinguish clinical concerns arising from disability from those related to other health conditions,” and that this “lack of familiarity and understanding of disability is detrimental for quality of care, contributing to delays in diagnosis and treatment, unsafe care, and inequities in care.” Finally, the NCD underscored the importance of effective communication between caregiver and patient—“[i]f either the patient or health care provider lacks clear understanding of the information conveyed,” the NCD stressed, “the delivery of care is compromised.”
The attorneys at Brown, Goldstein & Levy have experience assisting clients who were not provided appropriate accommodations by their healthcare providers. We assist such clients as part of our nationwide disability rights practice, which strives to ensure that individuals with disabilities from California to Maryland receive accommodations they need when visiting a hospital, attending a baseball game, taking a standardized test, or logging onto a website.
If you have a disability and have been denied an accommodation when visiting a healthcare practice, or if you have any questions about your right to disability-related accommodations under federal law, contact us today to discuss your situation.