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Sunday, May 31, 2009

Teaching, Silence and No Progress

If readers have noticed a sudden lack of entries to my blog, I can explain. I am just about to enter the third week of a summer intensive class at Purchase College. I lecture daily from 9AM to 12:40PM. This is a back breaker for me and the students who will earn an amazing four credits in three weeks. I leave the house early, get home mid afternoon and prepare for the next day. This may not sound like much but believe me when I say college course require a tremendous amount of prep work. At least the class, Body Art and Modification, is amenable to visual aides--I show a film or clips from You Tube every day. The material covered is of great interest to college students and they all seem as happy as possible.

Obviously my time is severely limited and accounts for my silence. I am inspired to write today because I was deeply moved by what Steve Kuusisto wrote on his always outstanding and interesting blog Planet of the Blind. The entry that moved was posted a few days ago and regarded surgery Steve had that restored some vision. I read this entry at my doctors office. I was having a check up for my high blood pressure which has proven very easy to maintain. Once my name was called I was amused to see that after two years the exam table at this medical mill remains totally inaccessible. Here I use medical mill as the practice is very large, well over 100 full time MDs. I wrote to the director of medicine to complain about the lack of access two years ago. This man agreed an accessible table is needed. The doctor I see agreed an accessible table. Fast forward one year. Again I wrote to complain an accessible table was needed. The director of medicine agreed again. My doctor agreed as well. Last week when my doctor entered the examination room he remarked "Look at what great progress we have made in the last two years getting an accessible examination table". I loved the sarcasm but not the results. After confirming my blood pressure is well under control each of use fired off yet another email to the medical director. I am sure these emails will produce the exact same result--no action. The sad fact is that until this practice is sued I see no reason to expect an accessible examination table will ever appear. So much for doctors being caring and sensitive to the need of patients. The utter disregard for wheelchair access at doctor offices never ceases to maze me. On top of this many hospitals I have visited are grossly inaccessible as well. Why does this happen so often? To me it all boils down to money. Like it or not, doctor offices are a business. I am sure some bean counter and lawyer at the large practice I go to regularly can explain in detail why they are not breaking the law. What they don't get is the gross inequity involved. What I think when I enter the examination room and see an inaccessible table year in and year out is just how unequal I am to my fellow citizens that can walk. Pardon my French but what a bunch of bastards.


Mia said...

And what about for wheelchair users who plan to go to med school. Or doctors who become wheelchair users? Shouldn't examination tables be accessible to both examiner and examinee?

william Peace said...

Mia, You make some very good points. I keep thinking of the elderly. Why should older folks struggle to get up on an antiquated exam table. The use of an accessible table has wide applications for doctors and patients.

Full Tilt said...

I completely agree but nothing will change until the medical directors and all of the dumb docs who practice there meet another doc who uses a chair or get sued by someone with the time, money and energy for that, as you've said. If I were a doc there, I'd get everyone together and find out the cost of a table and take up a large collection. We'd start buying just one, and then, if the medical director wasn't convinced, ask patients to write in protest. You can't be the only disabled individual to go to that office...

I'm glad you posted as I was wondering if you were okay and about to send an inquiry.

Elizabeth said...

I hear you. I just posted recently on my own blog about the brand new hospital built in Los Angeles, designed by I.M. Pei that doesn't have enough beds. Yup.

I'm new to your blog and looking forward to reading more. Thanks for the anger and the well-placed righteousness -- I like to hear it.

william Peace said...

Full Tilt, The cost of an accessible table is shocking. It easily costs four times the amount of a standard exam table. For your average small practice I could understand why MDs would be hesitant to spend this money. But when you have 100+ MDs there is simply no excuse.

Elizabeth, There are hundreds if not thousands of hospitals that are grossly inaccessible. Even those that are accessible have many patient rooms that have no accessible bathroom. I wonder is the failure of architects or medical complex planners. I.M Pei is a great architect in that his building are very cool. But wheelchair access in all his buildings is present but far from welcoming. Every time I enter one of the buildings he designed I am going to an obscure entrance or using multiple elevators to get to a specific location.

Claire said...

Ibid in Canada. They are technically "accessible"...ramps, elevators, yes. But functionally not so. For a kid with severe disabilities, there are never any full sized change tables, no place to lay down for the 3 or more hour waits they put you through. Not to mention doctors are afraid of my kid...except for the neurologist and neurosurgeon. didn't mention your 7 hour wait...unacceptable for a child with seizure disorder. The other thing is lifts...not a Hoyer to be found. Last blog I read had Dream Mom desperately searching for way to lift her 170lb son with no tone out of a bed into his chair. If one is found, NO ONE KNOWS HOW TO USE IT. Absolutely appalling.

Katja said...

"I.M Pei is a great architect in that his building are very cool. But wheelchair access in all his buildings is present but far from welcoming."

Agreed - I used to work at the NCAR Mesa Lab, and parking and wheelchair access are abysmal.

FridaWrites said...

Mia, one thing that has always concerned me in terms of the potential for abuse is the medical exam required of applicants to medical school (as well as to nursing school, PA school, midwifery school, etc). While some people may have limitations, they can choose to work in certain specialties that better accommodate any limits (such as radiology if as physically limited as I am). My concern is that many people may not make it through the door in the first place when someone else is deciding what one's limitations are. One has to be able to make it through the physical demands/long hours of residency, but it's worrisome when someone else decides who can or can't. I currently could not, although some would think I could while excluding someone who had to use a wheelchair at all times.

My rheumatologist has an adjustable table and just moved into a new suite in the same building--paid for reconstruction that made the offices bigger and easier to get around. This is definitely the exception, and he is a rarity. It seems like an adjustable table would really benefit one of my doctors, who is extremely short. The only other people I've seen with these are PTs and chiropractors.

There were successful suits/settlements under ADA against doctors' offices for not having an adjustable table (and one for not having an interpreter). This really has not changed anything for other businesses, just as lawsuits against clothing companies really haven't changed anything with other clothing companies--everyone hedges their bets that they won't get sued too.

Why I don't file suit when I need access: because I could easily invest all my time doing so and need to choose my battles. I guess I'd rather be more believable when something is truly inaccessible and it affects my life in even more substantial ways--such as living conditions or employment. I.e., I wouldn't want to lose credibility by having multiple lawsuits. It seems that telling people would be enough.

William, what about writing a letter citing the number of times you have requested it and the particular cases? This might lead to change. Unfortunately, other sources mention that getting assistance transferring can also qualify as an accommodation (I predict I feel the same way as you about that).
But see the two cases mentioned in:
With a 100-person practice there really seems not to be an excuse, and they are limiting a lot of people.

Recently I was looking up something on our state medical board website (am looking for a new pcp); there's a yes/no for each phsyician as to whether his or her office is accessible. Every physician said yes; I didn't see any who said no. I laughed to myself, able to find specific examples of where the physician said yes and the office is 100% inaccessible.

Sorry to be rambly since your schedule is tight!

william Peace said...

Well, I really hit a cord here. There is a giant difference between access in name and access in reality. This is true of doctors offices, schools, universities, and other institutions. I wish I could burn all those little blue wheelchair symbols because in my experience they mean nothing.

Claire, I often wonder what parents do who have kids with disabilities. I have never seen a hoyer lift for instance in a medical office. Do MDs simply examine kids sitting in a wheelchair? This is very bad in my estimation as the message sent screams inequality. As for those long waits, things have not changed in 30+ years. I spent way too much time in waiting rooms as a child.

Katja, Many famous architects design buildings that look great but are a nightmare in terms of function. Pei is just one of many such people. I would think at some level wheelchair access is valued but I must be wrong. Way too often access is a tacked on ugly after thought.

Frida, I mentioned in my email I am three years into asking for an accessible table. Last year the medical director said they were "working on it" but it might be a while before any action takes place. In the meantime I was told they would be happy to make any "reasonable accommodation". What gets me is the wide application of an accessible examination table. How about one per floor for a grand total of three. When I got blood drawn, in the hallway because the room where blood is drawn was not accessible, I saw some older woman struggle to get up and sit on an exam table. Ugh.

As for law suits, I have only filed a formal complaint once against Northwest Airlines. I could spend every waking second suing businesses and schools for a lack of access. This is a waste of my efforts.

Becs said...

Glad to see you're back. Better to work than not.

The dr's office I go to used to be the headquarters for a major brokerage firm. They renovated but I can think of at least three things right off the bat that are difficult, if not impossible, to access.

william Peace said...

Becs, Yes, mistakes are made all the time. Just this week I pointed out to the college I am teaching at no curb cut exists where I park. I requested a curb cut be put in. I was told to enter the building from handicapped parking where a curb cuts exists. Aside from the fact this comment misses the point, handicapped parking is always full and I can never find a spot hence my request. If I entered where requested I would need to navigate an extra 50 yards. Frustrating in the extreme.