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PARTIAL TRANSCRIPT:
MARY LOUISE KELLY, HOST:

Lisa Iezzoni uses a wheelchair to get around, which I mention because it is relevant to this next story about a new study that finds some doctors don't want patients with disabilities. In a series of anonymous interviews with 22 U.S. doctors, some admitted to refusing care to people with disabilities, making the excuse that they weren't taking on new patients. One specialist called them a disruption to the practice. Other physicians reported sending people in wheelchairs to supermarkets or zoos to take their weight, saying they lacked the right equipment in their offices. Well, these findings appear in the journal Health Affairs, and Lisa Iezzoni is the senior author. She's a doctor herself and a professor of medicine at Harvard. Dr. Iezzoni, welcome.

LISA IEZZONI: Thank you for having me.

KELLY: How did this study come about?

IEZZONI: I have been working on disparities in health care for people with disabilities for about 20 years, and had interviewed probably 300 people with different types of disabilities. And through all those interviews, I kept hearing complaints about doctors. You know, doctors don't understand their lives, don't understand their health problems, don't recommend services to them. And so I finally decided, after 20 years of talking to patients, it was time to talk to doctors. And, you know, since I'm on a Zoom screen, they couldn't see the fact that I was sitting in a wheelchair. And so I tried to kind of keep aspects of my identity free from them. And as they started saying some of the things that were a little bit troubling, I just said, that's interesting. Tell me more - and they did.

KELLY: And what what were they saying? Give me some examples of what you heard.

IEZZONI: Well, they were talking about how they found patients with disabilities to be entitled, to want accommodations that the physician didn't think that they needed, to come in with kind of an attitude, if you will. But also, physicians talked about the fact that they didn't feel equipped to be able to care for these patients who were coming in. It was - virtually universal statement that they didn't have, you know, the exam tables or the weight scales. And in one case, a rural physician said that the patients couldn't even get into the office because of barriers to accessing the office. So there were just a lot of concerning things about feeling unequipped in addition to not feeling they had enough time to do so.

KELLY: And before we get to what might be informing that, I just want to better understand. We've been talking about wheelchairs and people who have mobility issues getting into and out of an office. What other accessibility issues came up?

IEZZONI: Oh, my goodness. Communication was a really big thing. You know, doctors kind of said, well, if my patient is hard of hearing, I just talk to their companion. There was virtually no interest in doing something like hiring an American Sign Language interpreter if somebody was deaf and that was their preferred mode of communication. And so that was also true for people with intellectual disability that, although best practice is to speak directly to the person with intellectual disability, no, these doctors said that they would speak to the companion or the person accompanying the patient.

KELLY: As a doctor yourself, how surprising is this?

IEZZONI: It it is very concerning because the Americans with Disabilities Act passed in 1990. And so we've had literally decades to set up the system to be able to care equitably for people with disabilities, but it just still hasn't happened.

KELLY: Right. I mean, just to underscore what you're saying, physicians can't legally discriminate against people with disabilities because of the Americans with Disabilities Act.

IEZZONI: That's exactly right. They're supposed to provide equitable care to patients with disabilities. And they are supposed to provide reasonable accommodations.

KELLY: So how is this happening? How are these doctors getting away with turning patients away? Is it just not being reported?