Do Better by Disabled Patients

MORE THAN ONE IN FOUR AMERICANS live with some form of disability. This leads most of them to have an intimate, but far from untroubled, relationship to the health care system. One persistent source of frustration is a sense that clinicians may not be offering them the same care that other patients get. This hint of bias came to the fore during the COVID-19 pandemic, where those with disabilities were often put "in the back of the line" when it came to ventilators and other scare resources, says Lisa Iezzoni, a researcher at the Health Policy Research Center of Massachusetts General Hospital. People with disabilities have also had a harder time receiving priority in vaccination, though they face a greater risk of severe infection. Iezzoni has been studying the health care experiences of people with disabilities for more than 20 years. In February, Iezzoni published a pioneering paper in Health Affairs that tried to get to the bottom of physician attitudes. Among other findings, she discovered that 82 percent of surveyed physicians said people with a significant disability have a worse quality of life than nondisabled people—an attitude that may help explain why these patients are offered fewer screenings and other forms of care. "Physicians go into medicine to cure, to make people better," says Iezzoni. When faced with a patient with chronic and unfixable problems, the clinician might not be as adept at offering the patient the next best thing, which is the best life with the bodies they have. Such a focus on quality of life is at the heart of a number of relatively new disciplines, says Iezzoni, such as palliative and geriatric care. Listen to the podcast below, and subscribe to future episodes on iTunes, Stitcher and other platforms.