People with Disabilities Need Disability-Trained Physicians

Sept. 11, 202412 AM Central

Texans with disabilities face enough challenges. A lack of disability-competent healthcare shouldn’t be one of them.

“More than 3.6 million Texans — a population bigger than Dallas, Fort Worth, and Austin combined — have a disability, according to the U.S. Census Bureau.”

More than 3.6 million Texans — a population bigger than Dallas, Fort Worth, and Austin combined — have a disability, according to the U.S. Census Bureau, and it’s estimated that more than 13 percent of them have an intellectual or developmental disabilities (IDD) such as autism spectrum disorders, Down Syndrome, or Cerebral Palsy.

That’s a lot of our friends, family, neighbors, and colleagues, and they experience many of the same illnesses and injuries that everyone else does. But for far too many, healthcare doesn’t heal that pain; sometimes, a trip to the hospital or doctor’s office can even make it worse. This represents a massive and tragic health equity issue in Texas and beyond. Addressing it starts with medical training that is inclusive of disability education, and that includes training by people with disabilities.

There is a concept in medicine, called “diagnostic overshadowing,” in which doctors and other providers mistakenly attribute someone’s behavior to their disability, not an underlying — and treatable — cause of pain. When people without disabilities have common but painful conditions (think dental abscesses, gastroesophageal reflux, and bowel blockages), diagnoses and treatments are usually straightforward.

“A patient might not get a critical preventative screening because it’s harder for a provider to administer it. Perceptions and bias can also make it harder for people with IDD to get life-saving health treatments, especially if providers think the patient already suffers from a poor quality of life.”

But when someone with IDD experiences these symptoms, they may express pain through actions that are considered “adverse” behaviors. Unfortunately, many providers mistakenly attribute these behaviors to a patient’s disability. A patient might not get a critical preventative screening because it’s harder for a provider to administer it. Perceptions and bias can also make it harder for people with IDD to get life-saving health treatments, especially if providers think the patient already suffers from a poor quality of life.

“A Harvard Medical School survey found that only 41% of physicians feel “very confident” about their ability to provide the same level of care to patients with disabilities.”

The scope of this problem is alarming. A Harvard Medical School survey found that only 41% of physicians feel “very confident” about their ability to provide the same level of care to patients with disabilities. This contributes to a culture of fear and uncertainty, as people with IDD are at the mercy of a healthcare system that doesn’t understand their needs.

“Disabled adults are “more likely to experience chronic conditions such as cardiac disease, diabetes, higher weight, and asthma and to lack emotional support,” according to a 2022 study. They need care that’s better attuned to their individual health needs.”

Further, disabled adults are “more likely to experience chronic conditions such as cardiac disease, diabetes, higher weight, and asthma and to lack emotional support,” according to a 2022 study. They need care that’s better attuned to their individual health needs. Unfortunately, that care is often worse.

“Too few schools have carved out enough space in their curriculum to teach students about the specialized care that people with IDD need.”

The roots of this issue reach into medical schools themselves. Too few schools have carved out enough space in their curriculum to teach students about the specialized care that people with IDD need. There also are relatively few experts working in this field; even if every medical, nursing, dental, and allied health professional school wanted to hire an IDD clinical expert, they would have difficulty finding enough of them.

Long-term, it’s vital that the medical education community incorporate such training across healthcare disciplines. A report last year by the U.S. National Council on Disability listed five foundational measures needed to end health disparities for people with disabilities; one of them is to require “comprehensive disability clinical-care curricula in all US medical, nursing and other healthcare professional schools” and “disability competency education and training of medical, nursing and other healthcare professionals.”

“Technology and remote learning programs can help bridge the gap.”

In the meantime, technology and remote learning programs can help bridge the gap. For instance, Wellpoint Texas recently partnered with IntellectAbility to give Texas physicians and other clinicians free access to an online course (which has been approved for continuing medical education credit) that teaches providers about health risks facing Texans with IDD. The training helps medical professionals create better health outcomes and improve these patients’ healthcare experience and quality of life.

“Training helps medical professionals create better health outcomes and improve these patients’ healthcare experience and quality of life.”

Texans with IDD experience the same illnesses and injuries that affect all of us. They deserve the same level of care.

Disability-informed and competent medical education will help ensure they get it.

Texas clinicians can learn more and register for the no-cost training here.

Wellpoint Texas is a managed care organization serving nearly 750,000 Texans who participate in the state’s Medicaid programs.

By IntellectAbility President Dr. Craig Escudé and Wellpoint Texas President Greg Thompson