One-fourth of adults in the United States—61 million people—have a disability that affects activities such as mobility, hearing, vision, and cognition. Nearly 30 years after the passage of the Americans with Disabilities Act, people with disabilities continue to report difficulty accessing care because of cost, transportation challenges, or physical barriers.

Even if patients with disabilities can get to the doctor, they are less likely to receive a complete examination, especially if they use a wheelchair. In addition, female patients with disabilities are less likely to receive gynecologic examinations or Pap tests. Here are six actions that office-based physicians can take to improve care for patients with disabilities.

1. Complete a disability-competency checklist (such as those developed by the Institute for Healthcare Improvement and Harris Family Center for Disability and Health Policy) to uncover barriers to care.
2. Train staff on disability-competent care so that they can be more responsive to patient needs. Training should cover respectful language, use of special equipment, and approaches for detecting and resolving barriers to optimal care. Training may be available through state medical associations, government agencies, or nonprofit organizations.
3. Collect and document information about accessibility needs when scheduling appointments. Whether patients call for an appointment or schedule online, make sure to ask whether they need assistance to access care and note the response in their patient record for future visits.
4. Make sure you have the necessary equipment to conduct full examinations on patients with disabilities. Height-adjustable examination tables, platform scales, and lift equipment are examples of tools that can benefit patients as well as staff. For example, a recent study found that patients of all abilities reported more effort, difficulty, and safety concerns when mounting a 32-inch fixed-height table than an adjustable-height table. Moreover, providers report that adjustable tables allow them to conduct physical examinations more comfortably and safely.
5. Ask patients with disabilities for feedback on office layout and equipment. Many offices can benefit from advisory committees composed of patients, family members, and staff to identify and eliminate barriers to care.
6. Provide information in different formats, including large print, audio, and braille. People with vision impairment report the least access to care. Tactile signs allow patients to navigate your facility, and websites allow people to resize text and use text-to-speech technology.

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