Access to Subspecialty Care for Patients With Mobility Impairment A Survey

Background: Adults who use wheelchairs have difficulty accessing physicians and receive less preventive care than their able-bodied counterparts. Objective: To learn about the accessibility of medical and surgical subspecialist practices for patients with mobility impairment. Design: A telephone survey was used to try to make an appoint-ment for a fictional patient who was obese and hemiparetic, used a wheelchair, and could not self-transfer from chair to examination table. Setting: 256 endocrinology, gynecology, orthopedic surgery, rheu-matology, urology, ophthalmology, otolaryngology, and psychiatry practices in 4 U.S. cities. Patients: None. Measurements: Accessibility of the practice, reasons for lack of accessibility, and planned method of transfer of the patient to an examination table. Results: Of 256 practices, 56 (22%) reported that they could not accommodate the patient, 9 (4%) reported that the building was inaccessible, 47 (18%) reported inability to transfer a patient from a wheelchair to an examination table, and 22 (9%) reported use of height-adjustable tables or a lift for transfer. Gynecology was the subspecialty with the highest rate of inaccessible practices (44%). Limitation: Small numbers of practices in 8 subspecialties in 4 cities and use of a fictional patient with obesity and hemiparesis limit generalizability. Conclusion: Many subspecialists could not accommodate a patient with mobility impairment because they could not transfer the pa-tient to an examination table. Better awareness among providers about the requirements of the Americans with Disabilities Act and the standards of care for patients in wheelchairs is needed