By Abha BhattaraiThe Daily Northwestern
Patients with physical disabilities often face obstacles during routine health care procedures because of substandard equipment, inaccessible centers and untrained health care providers, according to an article by Feinberg School of Medicine Prof. Kristi Kirschner.
The solution, Kirschner said, is promoting equipment with “universal design” that can accommodate “as many body types as possible.”
The article, entitled “Structural Impairments that Limit Access to Health Care for Patients with Disabilities,” was published last month in the Journal of the American Medical Association. The article was co-authored by Mary Lou Breslin and Lisa I. Iezzoni.
Northwestern Memorial Hospital has been “creative” in its efforts by adding mammogram machines that can be lowered to wheelchair height and by offering breast ultrasounds as an alternative to mammograms for disabled women, Kirschner said.
“This isn’t about developing a separate system, but to use structures that can accommodate a range of people,” said Kirschner, who is also the medical director of the Women with Disabilities Center at the Rehabilitation Institution of Chicago.
“Part of the equation is, ‘What’s the limitation of the equipment? Is there an alternative we could use if needed?,’ ” she said.
Between 10 and 20 NU students – about five percent of the students served by the Office of Services for Students with Disabilities – are physically disabled, according to Margie Roe, office coordinator.
Roe added that there have not been any complaints about campus health facilities or the Searle Student Health Service.
Searle is wheelchair accessible, but Roe said she does not know whether it has examination tables or other “universal design” equipment.
Employees from the health center declined to comment.
“Structural access is, in a sense, the easiest piece of the puzzle,” Kirschner said. “It’s obvious if you’ve got stairs and the patient’s a wheelchair user. It’s easy to tell if the exam tables are too high and require people to be lifted onto them.”
But, she said, other problems are just as pervasive: communication barriers, a lack of translators for deaf and blind patients and untrained staff.
Kirschner added that “unconscious or subtle” pre-conceived notions about disabled patients can also lead to neglect.
“If you don’t think a woman who is in a wheelchair can be a sexual partner or become pregnant or be a mother, then those issues just don’t get addressed,” she said.
Furthermore, Kirschner said, disabled women are more susceptible to domestic violence as well as physical and emotional abuse. She added that there is only one wheelchair-accessible domestic violence shelter in Chicago.
“A lot of the abusers are the people that the patient depends on for care,” she said. “Even if they try to seek help, access to mental health services and domestic violence shelters is almost impossible.”
Judy Panko Reis, director of the Women with Disabilities Center at the Rehabilitation Institute of Chicago, said the problem is multifaceted with no easy solution.
“The main problem is structural, but underneath that is attitudinal problems,” Reis said. “In the end, it all boils down to attitudinal issues in society.
“Attitudes take a long time to change, but structural barriers don’t,” she said. “So that’s where we need to start.”
Reach Abha Bhattarai at [email protected].
