Study: Doctors’ negative views of disabled patients affect quality of care

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In a survey of 714 practicing U.S. physicians nationwide, only 40.7% said they were very confident about their ability to provide the same quality of care to patients with a disability as they do to nondisabled patients.

Researchers at Harvard Medical School and Massachusetts General Hospital conducted the study, and they found doctors negative perceptions of disabled patients were so widespread they called it “disturbing.”

“More than sixty-one million Americans have disabilities, and increasing evidence documents that they experience health care disparities. Although many factors likely contribute to these disparities, one little-studied but potential cause involves physicians’ perceptions of people with disability,” the researchers wrote.

The study was published this week in the journal Health Affairs.

The survey also found that 82.4% of the doctors said people with significant disability have a worse quality of life than nondisabled people, and only and 18.1% strongly agreed that the health care system often treats these patients unfairly.

“We wouldn’t expect most physicians to say that racial or ethnic minorities have a lower quality of life, yet four-fifths of physicians made that pronouncement about people with disabilities. That shows the erroneous assumptions and a lack of understanding of the lives of people with disability on the part of physicians.” said Dr. Lisa Iezzoni, lead study author and professor of medicine at Harvard Medical School, based at the Health Policy Research Center of Massachusetts General Hospital in Boston.

“Our results clearly raise concern about the ability of the health care system to ensure equitable care for people with disability,” added senior author Dr. Eric G. Campbell, professor of medicine and director of research for the Center for Bioethics and Humanities at the University of Colorado Anschutz Medical Campus.

The paper cites examples of how individuals with disabilities often receive inferior care. For example, many doctors assume that women with breast cancer who use wheelchairs want a mastectomy instead of breast-conserving surgery, believing these women don’t care about how they look.

Another example was from the early months of the coronavirus pandemic. The Office for Civil Rights at the U.S. Department of Health and Human Services issued a warning to health care providers that people with disabilities should not be denied medical care on the basis of disability or perceived quality of life.

“Studies of people with disability show that most don’t view their lives as tragic,” Iezzoni said. “They’ve figured out how to get around in the world that wasn’t designed for them and view their lives as good quality.”

The researchers said all levels of medical education, including continuing education for practicing physicians, should include training about disability. Most medical schools don’t include disability topics in their curricula, they added.