title: Make no assumptions: communication between persons with disabilities and clinicians.
abstract: Fundamentally improving health care quality requires providing care that respects patients' preferences, needs, and values. This goal holds special resonance for persons with disabilities, many of whom find others defining and circumscribing their lives and opportunities. Achieving patient centeredness demands open communication between patients and clinicians, unhampered by prior and often erroneous assumptions about patients' goals, aspirations, and abilities. Building on this communication, optimal care involves collaboration between patients and clinicians, each bringing his or her particular expertise to the table. Interviews with individuals with diverse disabilities revealed a common theme of faulty communication between patients and clinicians. Some shortfalls relate to basic failures to accommodate communication needs, whereas others result from clinicians' erroneous perceptions of medical aspects of persons' underlying conditions, the role of assistive technologies, and how disability affects people's daily lives. Crafting collaborative care partnerships between patients and clinicians requires transforming traditional patient-clinician relationships. Following two basic precepts immeasurably improves communication between clinicians and patients with disabilities: first, make no assumptions, and second, just ask patients about their needs and preferences.
authors.affiliation: Division of General Medicine and Primary Care, Department of Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, Massachusetts 02215, USA.
authors.forename: Lisa I
authors.initials: LI
authors.lastname: Iezzoni
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D003142:Communication; D003144:Communication Barriers; D006233:Persons with Disabilities; D005260:Female; D006801:Humans; D008297:Male; D018802:Patient-Centered Care; D011369:Professional-Patient Relations; D011787:Quality of Health Care