Access to Health Care
Making Services Available
Since 1992, the Americans with Disabilities Act (ADA) has required healthcare professionals to make accommodations so their services remain available to persons with disabilities.
It also prohibits them from charging a higher fee or attempting to recover any portion of the cost of the accommodation, even if that cost exceeds the fee they charge for their services.
Healthcare professionals include doctors, nurses, dentists, chiropractors, massage therapists, psychotherapists, and many others.
The thinking goes something like this: Healthcare professionals provide services to a community that in turn provides them with a livelihood.
As part of the cost of doing business, they're expected to absorb the occasional expense of accommodating disabled people from the community they serve.
For example:
- A hearing-impaired person wants to begin psychotherapy but requires a sign-language interpreter. The therapist is responsible to pay for the interpreter out of their own pocket.
- A client becomes too disabled to climb the steps to the office of a long-time massage therapist. The massage therapist must provide alternative arrangements without passing along any portion of the associated costs.
- On the first visit to a new dentist, a person in a wheelchair discovers that the restroom does not comply with ADA standards. The dentist must upgrade the restroom or provide alternate facilities.
A No-Win Situation
Unfortunately, the burden of enforcement falls on the shoulders of the disabled. This places them in awkward, even untenable positions. If the dental patient in the last example sued the dentist, doing so would most likely jeopardize and possibly destroy a sensitive relationship. Would you want that dentist drilling in your mouth?
Some years ago I attempted to resume therapy with someone I had seen several years prior, before I was in a wheelchair. Because the office was not accessible, we discussed meeting at my office instead. However, she wanted to charge for an extra hour to cover travel time. The ADA expressly forbids such an arrangement. I could have forced the issue and ended up with a resentful therapist—not a good basis for successful therapy! Instead, I chose to let the matter drop and sought therapy elsewhere.
As a licensed psychotherapist myself, I remind colleagues that our services must be accessible to everyone--not only to fulfill our ethical obligations, but to uphold the law as well. (You can visit the website for my private practice by clicking here.)
In addition to providing equal access to their physical offices, healthcare professionals need to make sure their websites comply with the latest Web Content Accessibility Guidelines (WCAG). This is an evolving technical standard that is developed internationally and generally known to website designers. WCAG 2.1 was expected to be upgraded to WCAG 2.2 in 2021.
In Summary
Healthcare professionals bear the responsibility for being proactive in accommodating the needs of the disabled. Otherwise, they put their disabled clients in the no-win position of having to enforce their civil rights against the very people who should be attending to their well-being.
