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Physicians’ attitudes about caring for people with disabilities

healthaffairs.org

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Re: Physicians’ attitudes about caring for people with disabilities

#41

Post by knaekhoved »

logicalmonster wrote: post #2

Could the ADA itself be the cause of at least some of this hesitation by some doctors to want to deal with disabled patients? With a disabled patient, there's a larger chance that something about your medical practice (the parking lot, the hallway, the stairs and ramps, the chairs in the waiting room, the equipment in your office, etc) aren't going to satisfy somebody and you're faced with a dumb legal headache even…

Absolutely - the ADA makes it incredibly risky to deal with disabled people in any kind of formal interaction, so anyone who can avoid it rationally will do so.

Re: Physicians’ attitudes about caring for people with disabilities

#42

Post by knaekhoved »

Arisaka1 wrote: post #26
candiddevmike wrote: post #13

Earlier quoted context omitted.

Does this apply globally or just in the US? Do folks in other countries with disabilities have better experiences?

I am far from disabled but I have multiple chronic issues, one of them being 100% visible to the naked eye and I've been told by multiple doctors to "not stress about it". And we're taking about a nail color change, a fingers temperature change during winter, and a constant feeling of headache that feels like worms are throwing a party under my hair (which they clearly don't). Also, for what it's worth, I'm from Euro…

> And we're taking about a nail color change, a fingers temperature change during winter

This sounds like pretty normal stuff...

Re: Physicians’ attitudes about caring for people with disabilities

#43

Post by User23 »

kayodelycaon wrote: post #32
Test0129 wrote: post #20

Earlier quoted context omitted.

I dunno, that's the point. Since it only technically requires "reasonable accommodation" it's up to interpretation. "Reasonable accommodation" has been used by ambulance chasers to sink businesses. I'm sure a set of absolutes could be codified. I'm getting downvoted to death for having an opinion again so I'm just gonna leave the topic.

Reasonable accommodation isn’t significantly onerous in the vast majority of cases. You don’t have to provide the accommodation a person wants. For example… - Ordering via phone could be an acceptable accommodation for an inaccessible website. (Just don’t place the person on hold for half an hour.) - Pen and paper can be used for communication when verbal communication isn’t possible. - If someone is blind, you may b…

> If someone is blind, you may be able to read things for them.

You should see the look on the receptionist’s face when she has to, oh no, fill out the stupid overly repetitive paperwork doctors give their patients. The last time I did it I had to fill out my name and address like five different times.

Re: Physicians’ attitudes about caring for people with disabilities

#44

Post by [deleted] »

lotsofpulp wrote: post #29
Test0129 wrote: post #20

Earlier quoted context omitted.

I dunno, that's the point. Since it only technically requires "reasonable accommodation" it's up to interpretation. "Reasonable accommodation" has been used by ambulance chasers to sink businesses. I'm sure a set of absolutes could be codified. I'm getting downvoted to death for having an opinion again so I'm just gonna leave the topic.

The ADA should have been the government providing disabled people with sufficient cash to purchase the services or products they need to address their disability, or the government can provide it directly. But by diffusing the responsibility across businesses, the government can say they helped people without spending any money or taking responsibility to help people. For example, why would a doctor need to arrange f…

[deleted]

Re: Physicians’ attitudes about caring for people with disabilities

#45

Post by marcinzm »

thepasswordis wrote: post #30

I really wish I could just (safely) order whatever medications, tests, and treatments I want online. Let me consult a doctor if I need one, but also: don't gatekeep treatment from me because the doctor is having a bad day, doesn't like me, etc. I have a severe , debilitating anxiety disorder. It's extremely frustrating, and sometimes I will have to leave classes I'm teaching, social functions, etc. for no apparent re…

Do you go to a different doctor every time, and is it a general doctor or a psychiatrist?

Re: Physicians’ attitudes about caring for people with disabilities

#46

Post by eska »

octokatt wrote: post #11

N=1, but I can confirm the experience of being disabled and getting medical care is mutually frustrating. Taylorism and one-size-fits-all fails hard. Appointment times are standardized, despite patients not being standard. I know I'm going to take extra time. I have multiple chronic conditions, getting treatment is a mess. But I can't arbitrarily ask for more time during booking; it's all automated now. Worse, I need…

* I'm making them go over time*

Saying this as a non-disabled person, please don’t think of it/word it this way. It’s not you, it’s the disability, and you’re not responsible for it. If you take some time because of it I would gladly accommodate you as a service provider and show understanding as the next patient in line.

Re: Physicians’ attitudes about caring for people with disabilities

#47

Post by VancouverMan »

lotsofpulp wrote: post #27
parkerhiggins wrote: post #18

Earlier quoted context omitted.

Spot on. It becomes more clear when you ask who pays medical professionals salaries? Insurance companies do. Insurance companies are medical professionals’ bosses. The customer receiving treatment has no influence on the standard of care.

Most customers could not afford the treatment at the standard of care they want anyway, hence the reason they purchase via insurance.

And those pricing distortions are due to significant government-imposed regulations and restrictions that tightly limit the supply of doctors and medical services, even in the face of increasing demand.

Re: Physicians’ attitudes about caring for people with disabilities

#48

Post by logicalmonster »

kayodelycaon wrote: post #32
Test0129 wrote: post #20

Earlier quoted context omitted.

I dunno, that's the point. Since it only technically requires "reasonable accommodation" it's up to interpretation. "Reasonable accommodation" has been used by ambulance chasers to sink businesses. I'm sure a set of absolutes could be codified. I'm getting downvoted to death for having an opinion again so I'm just gonna leave the topic.

Reasonable accommodation isn’t significantly onerous in the vast majority of cases. You don’t have to provide the accommodation a person wants. For example… - Ordering via phone could be an acceptable accommodation for an inaccessible website. (Just don’t place the person on hold for half an hour.) - Pen and paper can be used for communication when verbal communication isn’t possible. - If someone is blind, you may b…

> Reasonable accommodation isn’t significantly onerous in the vast majority of cases.

You are correct that a reasonable accommodation isn't particularly hard in many cases.

The disconnect in communication here is that you're thinking in terms of a reasonable person.

Unreasonable people exist.

There are unfortunately some disabled people that would refuse to be satisfied by almost anything you provide them. The ADA lawsuits don't magically vanish just because you try and be reasonable and they refuse to be satisfied in turn hoping for some payday.

The vast majority of disabled people are probably thankful for the accommodation, but it just takes 1 ambulance chasing jerk to pursue a dumb case that sinks a business.

Re: Physicians’ attitudes about caring for people with disabilities

#49

Post by fhsm »

ChrisMarshallNY wrote: post #5
CoastalCoder wrote: post #3

Earlier quoted context omitted.

I just assumed that ADA requirements made their way into commercial building codes a while ago. And because of that, physicians would rarely bump into that issue, whether leasing office space or building new space. Am I mistaken?

I believe that you are correct. The doctor's office, as a business, already needs to abide by the ADA. It could be a convenience store, and still have the same requirements.

This is true but really doesn’t capture much of the truth. As a first approximation you can split spaces into licensed and unlicensed spaces. The former are the conventional purview of “private practice”. The latter are the typical purview of “hospitals”. These are in quotes because this is merely a correlation and neither concept has a strict definition. Critically without domain knowledge it’s unlikely you’d be able to tell which a “doctors office” is.

An unlicensed space is a business with all the usual obligations and the doctor is a doctor with all the usual obligations. When you move to the practice of medicine to a “hospital” (again as a licensing and finance idea which is separable from a sort of basic idea of building X) all that comes along but now with an additional regulatory overlay.

Big picture this doesn’t change much about the Ada except to say that many medical practices are happening in spaces where the Ada is just the beginning.

Re: Physicians’ attitudes about caring for people with disabilities

#50

Post by lob_it »

I think anybody that saw the "pay to play" debacle with all of the medical journals at the turn of the century approach "medical and health (i call it healff, because they obviously got two "F's" in the subject) with realism and a bit of scepticism.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3702092/

"fabrication, falsification, and plagiarism" indicates the industry itself is beyond a crisis.

The comments/article show that a "for profit" system is everybody's problem, but even socialized healthcare does not provide even coverage for a long list of ailments.

The news coverage in Austrailia on Teo and neurosurgeons shows where disabilities as a plaything are equally as unethical.

https://www.news.com.au/lifestyle/health/neurosurgeon-charli...

The only recourse for disabled and ablebodied persons is to keep trying until you find a trained professional that can accomodate your specific needs (provided you can afford their services).

Perhaps people with disabilaties would be better served seeking healthcare at medical education facilities, where training/learning is still paramount versus the scar tissue already embeded in the system (not being paid for services from insurers, unreasonably low rates, etc).

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