Letter from the Editor

Beautiful silver stethoscope with reflection and blue tint

I know the medical community means well. But when dealing with people with disabilities, there is still a long way to go. This month we will be working with Washington State University students to map accessible medical offices in Pullman, Washington. Over the course of several days, each office will be looked at individually to see what their accessibility is like. The students will be looking for height adjustable exam tables, if there is room to transfer from chair to exam table, and things like providing sign language interpreters for complicated medical consultations for the deaf and large print or Braille medical documents for the visually impaired. Think about it – after years of not being able to see your medical statements, how nice receiving one in large print would be! This is private information that you don’t always want someone to “read” to you.

A survey done in 2013 determined that only 9% out of 256 health care facilities reported using height-adjustable exam tables or having a lift for transferring patients. Gynecology reported the highest rate of inaccessible practices. Hmmm – can’t imagine that exam done in a wheel chair;)

Some of these problems have simple solutions that have been around for centuries. Adjustable barber chairs have been around and changed very little in 100 years. It is common for digitized scales to be built into the floors for institutional laundries, yet hospitals and clinics refuse to install accessible wheelchair scales.

What accounts for the lack of accessible health care equipment for people with disabilities? Critics point to the medical model of disability as the culprit. Doctors see a person with a disability as someone that needs to be fixed. There are exceptions of course, but institutional bias has a way of compounding itself as it becomes embedding in the fabric of the health care delivery system. Lack of proper examination tools can result in signs of cancer being poorly evaluated or missed altogether. Failure to properly track weight fluctuations can result in improper dosage of medicines.

I know that when caring for my Mum, the doctor was more interested in solving her “cancer” on her ear than diagnosing her vascular dementia. Each return visit had that complaint dismissed as “old age” and again the ear cancer would be brought up. It took a nurse from Hospice to diagnose it immediately. Side note – the ear cancer was not life threatening and the treatment would have meant a dangerous surgery and discomfort afterwards.

What will it take to change the culture of a major industry? Lawsuits can force compliance involving physical access, but the most difficult obstacle to overcome is lack of awareness combined with an attitude of paternalism. They often think their factual knowledge is superior to your personal experience. It will take combined voices of assertion to make change. People with disabilities usually want to be less bothersome, so they don’t want to make waves. When you are sick and going through a crisis the last thing you want to do is hassle a lot of people. To affect change you have to get their attention. Be proactive. You will have to speak up! Be brave enough to take the next step.