title: Access to subspecialty care for patients with mobility impairment: a survey.
abstract: BACKGROUND
  Adults who use wheelchairs have difficulty accessing physicians and receive less preventive care than their able-bodied counterparts.
  
  
  OBJECTIVE
  To learn about the accessibility of medical and surgical subspecialist practices for patients with mobility impairment.
  
  
  METHODS
  A telephone survey was used to try to make an appointment for a fictional patient who was obese and hemiparetic, used a wheelchair, and could not self-transfer from chair to examination table.
  
  
  METHODS
  256 endocrinology, gynecology, orthopedic surgery, rheumatology, urology, ophthalmology, otolaryngology, and psychiatry practices in 4 U.S. cities.
  
  
  METHODS
  None.
  
  
  METHODS
  Accessibility of the practice, reasons for lack of accessibility, and planned method of transfer of the patient to an examination table.
  
  
  RESULTS
  Of 256 practices, 56 (22%) reported that they could not accommodate the patient, 9 (4%) reported that the building was inaccessible, 47 (18%) reported inability to transfer a patient from a wheelchair to an examination table, and 22 (9%) reported use of height-adjustable tables or a lift for transfer. Gynecology was the subspecialty with the highest rate of inaccessible practices (44%).
  
  
  CONCLUSIONS
  Small numbers of practices in 8 subspecialties in 4 cities and use of a fictional patient with obesity and hemiparesis limit generalizability.
  
  
  CONCLUSIONS
  Many subspecialists could not accommodate a patient with mobility impairment because they could not transfer the patient to an examination table. Better awareness among providers about the requirements of the Americans with Disabilities Act and the standards of care for patients in wheelchairs is needed.
  
  
  BACKGROUND
  None.
authors.affiliation: Center for Quality of Care Research, Baystate Medical Center, Springfield, Massachusetts 01199, USA. lagutc@gmail.com
authors.forename: Tara
authors.initials: T
authors.lastname: Lagu
authors.forename: Nicholas S
authors.initials: NS
authors.lastname: Hannon
authors.forename: Michael B
authors.initials: MB
authors.lastname: Rothberg
authors.forename: Annalee S
authors.initials: AS
authors.lastname: Wells
authors.forename: K Laurie
authors.initials: KL
authors.lastname: Green
authors.forename: McAllister O
authors.initials: MO
authors.lastname: Windom
authors.forename: Katherine R
authors.initials: KR
authors.lastname: Dempsey
authors.forename: Penelope S
authors.initials: PS
authors.lastname: Pekow
authors.forename: Jill S
authors.initials: JS
authors.lastname: Avrunin
authors.forename: Aaron
authors.initials: A
authors.lastname: Chen
authors.forename: Peter K
authors.initials: PK
authors.lastname: Lindenauer
mesh_terms: D000328:Adult; D001107:Architectural Accessibility; D006233:Persons with Disabilities / Q000331:legislation & jurisprudence; D019538:Health Care Surveys; D006297:Health Services Accessibility; D006801:Humans; D007407:Interviews as Topic; D055805:Moving and Lifting Patients / Q000295:instrumentation; D013038:Specialization; D014481:United States; D014910:Wheelchairs