"Access to Medical Care and the Americans with Disabilities Act: Educating Health Professionals as a Force for Culture Change"
Long-Bellil, L.M., Graham, C.L., Robey, K.L., Smeltzer,
S.C., Woodard, L., Reiss, J.G.
"The cultural context of law
both promotes and subverts efforts at legal change” (Engel, 1991). The
Americans with Disabilities Act (ADA) imposed requirements that medical
providers afford access to persons with disabilities and modify their policies,
procedures and practices to ensure that individuals with disabilities can
benefit from the “full and equal enjoyment” of their services (Americans with
Disabilities Act, 42 USC §12182(a)). These requirements were imposed on a
health care workforce whose attitudes and level of experience with persons with
disabilities, for the most part, rendered it no more prepared to respond than
the rest of society. It also had a culture that was perceived as inhospitable
to patients generally and was undergoing a transformation of its own due to
increasing resource constraints.
Twenty years later, despite
repeated calls from the Office of the Surgeon General (2002; 2005) and the
National Council on Disability (2009), along with lawsuits against several
large providers, individuals with disabilities continue to experience health
disparities and lack of access to appropriate care (Office of the Surgeon
General, 2002 and 2005; NCD, 2009). However, there is a nascent movement among
educators to provide the health care workforce with the tools it needs to
afford the access to care contemplated by the ADA. A new organization, the
Alliance for Disability in Health Care Education, comprised of educators from
various medical and nursing schools is actively working toward increasing the
inclusion of disability content in the curricula of schools of medicine,
nursing and other health professions. The goal is to instill positive attitudes
and appropriate knowledge and skills in emerging health care professionals.
This educational effort, combined with other initiatives at the federal, state
and local level may create the culture change necessary to ensure appropriate
and effective care for persons with disabilities.