Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

Addressing disparities in gynecological care for women with physical disabilities

Geffen Treiman
Policy
March 1, 2023
38 Shares
Share
Tweet
Share

I recently read a story in which a woman named H. Lee, who has muscular dystrophy, details a decade-long struggle to receive adequate cervical cancer screening. Providers have been unable to find her cervix due to the curvature of her spine, examined her in her wheelchair because there were no height-adjustable examination tables, and outright turned her away for “liability reasons.”

By the time she finds an accessible provider, she has not had a pap smear in four years. She is eventually diagnosed with a form of precancer called carcinoma in situ and must have her uterus removed. She writes, “I never wanted to have children. But, not to have a child was my choice, but now it was being taken away from me.”

Lee’s experience is not unique. In a study of more than 60,000 women in the United States, women with disabilities had lower odds of being up to date on pap smears and were more likely to be diagnosed with cervical cancer. These disparities pervade other areas of women’s health. Women with disabilities are also less likely to be up to date on breast cancer screening. They are more likely to undergo female sterilization and less likely to be on the pill than non-disabled women.

One of the many barriers to accessing gynecological care is the lack of height-adjustable examination tables. This leaves many women with mobility disabilities vulnerable to potential injury from unsafe transfers to and from their wheelchairs or unable to receive adequate examinations.

Several pieces of legislation exist to protect individuals with disabilities from experiencing discrimination in health care. These include Title II and Title III of the Americans with Disabilities Act, Section 504 of the Rehabilitation Act of 1973, and Section 1557 of the Patient Protection and Affordable Care Act.

Though the disability rights law within the US is arguably robust, the means of enforcing these protections are not. Currently, if an individual experiences discrimination based on disability status, they must file a report with the Department of Justice. This protocol places the burden on the individual. It can be time-consuming and financially burdensome.

We need a policy that is not reactive but rather prevents these injustices from occurring in the first place. It should incentivize clinics to be accessible and comply with the ADA. A tax credit in which women’s health clinics are evaluated based on the presence of height-adjustable examination tables as well as providing disability-focused training to staff may help to reduce inaccessibility of the physical environment. Both the Disabled Access Credit, which offers a tax credit to employers for expenditures related to accessibility, and the Architectural Barrier Removal Tax Deduction, which allows small businesses to receive a deduction of up to $15,000 per year for expenditures related to barrier removal, may serve as a model for this proposal. One potential weakness of this policy is that complying with the ADA can be expensive; it may not be financially worth it to many smaller clinics. Thus, the credit must outweigh the cost of examination tables and training.

Inaccessible examination tables are just one of many systemic and discriminatory factors impacting health access and outcomes for people with disabilities. Addressing them is important to ensure health equity and reproductive justice for all.

Geffen Treiman is a medical student. 

Prev

Reducing burnout and improving patient care with ambient clinical intelligence

February 28, 2023 Kevin 0
…
Next

Size-inclusive medicine: a response to AAP's guidelines for the treatment of children and adolescents with obesity

March 1, 2023 Kevin 1
…

Tagged as: OB/GYN, Primary Care

Post navigation

< Previous Post
Reducing burnout and improving patient care with ambient clinical intelligence
Next Post >
Size-inclusive medicine: a response to AAP's guidelines for the treatment of children and adolescents with obesity

Related Posts

  • How social media can help or hurt your health care career

    Health eCareers
  • Why eliminating health care disparities is easier said than done

    Martin Lustick, MD
  • The role of medical education in perpetuating health care disparities

    Anonymous
  • The solution to a crumbling primary care foundation is direct primary care

    Sara Pastoor, MD
  • Care is no longer personal. Care is political.

    Eva Kittay, PhD
  • Primary Care First: CMS develops a value-based primary care program for independent practices

    Robert Colton, MD

More in Policy

  • Physician well-being: Overcoming administrative hurdles

    Pat Rich
  • Health care’s hidden problem: hospital primary care losses

    Christopher Habig, MBA
  • From fishing licenses to gun control

    Mitch Bruss, MD
  • How the NFL offers a window into health care solutions for our country

    Renee Hsia, MD
  • Unlocking the potential of allied health roles for a thriving health care system

    Eric Stastny, MHA
  • Efficient staffing partners for health systems

    Patrick Dotts
  • Most Popular

  • Past Week

    • A physician’s cry in light of world events

      Fareeha Khan, MD | Physician
    • From fishing licenses to gun control

      Mitch Bruss, MD | Policy
    • Health care’s hidden problem: hospital primary care losses

      Christopher Habig, MBA | Policy
    • Embracing the Huntington’s disease community

      Erin Paterson | Conditions
    • The dark role of science, medicine, and tasers

      L. Joseph Parker, MD | Physician
    • Lacertus syndrome and the quest for diagnosis

      Dinaaz Lentin | Conditions
  • Past 6 Months

    • Medicare coverage saves lives. Enrolling shouldn’t be this complicated.

      Catherine L. Chen, MD, MPH | Physician
    • The erosion of compassion in medicine

      Daniel Luger, MD | Education
    • Emergency department burnout: a cry for change

      Anonymous | Conditions
    • Pain medicine realities: beyond the opioid crisis

      Richard A. Lawhern, PhD and Stephen E. Nadeau, MD | Conditions
    • AI in health care: a synergy of humans and technology

      Liudmila Schafer, MD | Tech
    • What we have to gain from weight loss drugs

      Hoag Memorial Hospital Presbyterian | Conditions
  • Recent Posts

    • The dark role of science, medicine, and tasers

      L. Joseph Parker, MD | Physician
    • Embracing life’s purpose in the face of inevitable death

      Michael Brant-Zawadzki, MD | Conditions
    • Beyond K-pop and kimchi: Unraveling the mental health tapestry of Korean Americans

      Dae Sun Hwang, Thomas Pak, MD, and Joo-Young Lee, MD | Physician
    • AI’s role in streamlining colorectal cancer screening [PODCAST]

      The Podcast by KevinMD | Patient, Podcast
    • A manifesto for the next revolution in nocebo and placebo studies

      Jeremy Howick, PhD | Meds
    • How to sell your losing stocks to reduce taxes

      Amarish Dave, DO | Finance

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 1 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

CME Spotlights

From MedPage Today

Latest News

  • De-Escalating Breast Cancer Treatment Feasible After Response to Neoadjuvant Chemo
  • Clinical Challenges: Hope and Caution in the Neurofibromatosis Drug Pipeline
  • Alarming Mpox Surge; Plan to Redo Lead Pipes Nationwide; Overdoses Reach High in SF
  • GOP Presidential Candidates Spar Over Transgender Care and Fentanyl Policy
  • ChatGPT Flubbed Drug Information Questions

Meeting Coverage

  • De-Escalating Breast Cancer Treatment Feasible After Response to Neoadjuvant Chemo
  • ChatGPT Flubbed Drug Information Questions
  • Tucatinib Regimen Boosts PFS in Advanced HER2-Positive Breast Cancer
  • Inappropriate Aspirin Use Continues, Research Suggests
  • Improvements With Guselkumab in Psoriatic Arthritis Seen Across All MDA Domains
  • Most Popular

  • Past Week

    • A physician’s cry in light of world events

      Fareeha Khan, MD | Physician
    • From fishing licenses to gun control

      Mitch Bruss, MD | Policy
    • Health care’s hidden problem: hospital primary care losses

      Christopher Habig, MBA | Policy
    • Embracing the Huntington’s disease community

      Erin Paterson | Conditions
    • The dark role of science, medicine, and tasers

      L. Joseph Parker, MD | Physician
    • Lacertus syndrome and the quest for diagnosis

      Dinaaz Lentin | Conditions
  • Past 6 Months

    • Medicare coverage saves lives. Enrolling shouldn’t be this complicated.

      Catherine L. Chen, MD, MPH | Physician
    • The erosion of compassion in medicine

      Daniel Luger, MD | Education
    • Emergency department burnout: a cry for change

      Anonymous | Conditions
    • Pain medicine realities: beyond the opioid crisis

      Richard A. Lawhern, PhD and Stephen E. Nadeau, MD | Conditions
    • AI in health care: a synergy of humans and technology

      Liudmila Schafer, MD | Tech
    • What we have to gain from weight loss drugs

      Hoag Memorial Hospital Presbyterian | Conditions
  • Recent Posts

    • The dark role of science, medicine, and tasers

      L. Joseph Parker, MD | Physician
    • Embracing life’s purpose in the face of inevitable death

      Michael Brant-Zawadzki, MD | Conditions
    • Beyond K-pop and kimchi: Unraveling the mental health tapestry of Korean Americans

      Dae Sun Hwang, Thomas Pak, MD, and Joo-Young Lee, MD | Physician
    • AI’s role in streamlining colorectal cancer screening [PODCAST]

      The Podcast by KevinMD | Patient, Podcast
    • A manifesto for the next revolution in nocebo and placebo studies

      Jeremy Howick, PhD | Meds
    • How to sell your losing stocks to reduce taxes

      Amarish Dave, DO | Finance

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Addressing disparities in gynecological care for women with physical disabilities
1 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...