Many Practices Not Accessible to Wheelchair Patients

WheelchairNearly one in four physician practices still is not able to handle disabled patients who use wheelchairs, a recent report in the Annals of Internal Medicine says. The results of the study raise questions about practice’s ability to handle a rapidly aging population. Is your practice ready?

The study, which examined 256 practices in four cities, found that 22 percent simply could not accommodate wheelchair-bound patients. Eighteen percent said they could not transfer a patient from a wheelchair to an examination table, while only 9 percent reported the use of height-adjustable tables or lifts for transfer. Gynecology practices were the least accessible, at 44 percent. Some specialties, such as ENT and psychiatry, were less hampered (being able to examine patients in their wheelchairs).

The expected, growing number of wheelchair-bound Baby Boomer patients presents a problem for most practices.  “The goal of the study was to increase awareness about the need for accessibility and to help doctors realize they may need to make adjustments in their practice,” quotes the lead author of the study, Tara Lagu, MD.

The American Medical Association enewsletter continues, “Dr. Lagu said a lack of awareness, liability issues, and time and cost concerns appeared to be the main reasons some medical practices don’t comply with the law, which states that all medical practices must provide ‘full and equal access to their health care services and facilities’ for patients with mobility impairment. This includes building accessibility as well as transfer from a wheelchair to an exam table.”

The problem for inaccessible practices is significant. Not only does inaccessibility block revenue, but it is illegal. The U.S. Department of Justice enforces the two-decade old American with Disabilities Act (ADA), which presents practices with additional liability.

The ADA, signed by President George H. W. Bush in 1990 and amended by President George W. Bush in 2008, is a civil rights law requiring medical practices, among others, to make public accommodations for people with disabilities. Title III of the ADA requires that patients, clients, or visitors with disabilities have full access to their facilities and services for effective healthcare. This includes interpretation services for those who cannot hear. And, assistance animals must be able to accommodate patients to appointments.

Tax deductions and tax credits are available for practices needing to upgrade to serve the growing patients. This is significant because adjustable height tables, specialized mammography and gynecology equipment, and mechanical lifts cost money. To assure compliance with the ADA, attention must be paid to the layout of the waiting room, width of hallways and doors, and ease of bathroom use.

Practices can receive a tax credit equal to 50 percent of the eligible access expenditures in a year, up to $5,000 in a year, and a maximum tax deduction up to $15,000 a year for removing architectural barriers.

Some inexpensive alternatives are available to manage wheelchair-bound patients. Some examination tables can be lowered to transfer patients easily. Local physical therapists can train staff to safely move patients from their chairs to existing tables.

Your practice should have policies to accommodate the disabled and staff should be trained. The DOJ Civil Rights Division has several helpful resources, as do your local medical associations.


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