Introduction
- People with developmental disabilities face numerous barriers when dealing with physicians.
- Poor communication.
- Short visit durations.
- Insufficient patient information.
- Lack of patient proper education.
People with developmental disabilities are likely to face numerous barriers when accessing healthcare services, specifically from physicians. The barriers to the access of satisfactory healthcare services among such individuals fall within broad themes. According to McClintock et al. (2016), some of these themes include poor coordination among different care providers, short durations during physician visits, giving insufficient information to patients, and failure to educate patients thoroughly. When dealing with patients with developmental problems, physicians may contribute significantly to these barriers, with or without their knowledge. Therefore, it is important to highlight these problems for physicians to be aware and come up with ways of addressing them for improved patient outcomes and satisfaction.
Issues Faced by Individuals with Developmental Disabilities
- Communication barriers:
- Poor physician-patient communication;
- Use of technical language by physicians;
- Patients feel neglected or invisible to physicians;
- Short visitation durations:
- Patients do not stay long enough with physicians;
- Lack of long and fruitful conversations;
- Patients get inadequate information;
- Non-compliance to treatment;
- Patient education:
- Lack of proper patient education;
- Other barriers:
- Lack of health insurance and finances;
- Poor transportation;
- Inaccessible facilities.
McClintock et al. (2015) argue that communication between patients with developmental disabilities and physicians is a common problem hindering the provision of quality care services. For instance, it may be difficult for physicians to communicate clearly with autistic patients (Dern & Sappok, 2016). Besides, physicians are known to use technical language, which might not be understood by patients with developmental disabilities, thus affecting the effectiveness of the communication. McClintock et al. (2018) argue that people with developmental problems are likely to communicate in ways that are different from what is used by those without the same health problems, and this aspect affects communication with healthcare providers. As such, some patients may feel neglected or invisible to physicians, thus affecting the quality of care provided and received, which ultimately leads to poor or negative outcomes.
People with developmental disabilities are likely to be in physicians’ office for a short time. McClintock et al. (2018) posit that healthcare providers may lack the requisite skills to engage such patients in long conversations. Therefore, these patients may spend brief periods with their physicians because long and fruitful conversations cannot be sustained. Consequently, the physician may fail to recognize some health conditions among such patients due to the lack of time to listen and learn from one another. This problem is linked to the barrier of patients receiving inadequate information from physicians. Roll (2018) found that when patients get insufficient information from care providers, they are likely to be non-compliant to directives, and this aspect leads to poor outcomes due to the affected quality of care.
In a study conducted by Selick, Durbin, Casson, Lee, and Lunsky (2018), healthcare providers noted that they face numerous challenges during patient education especially when dealing with people with developmental disabilities. Therefore, physicians are likely to face the same problems and fail to carry out the necessary patient education, thus affecting care outcomes negatively. Williamson, Contreras, Rodriguez, Smith, and Perkins (2017) argue that people with developmental disabilities face a myriad of problems, such as lack of health insurance coverage, insufficient finances, transportation, and inaccessible facilities. While physicians may be ready to serve such patients, their service delivery is hindered. These barriers ultimately affect the quality of care that physicians render to patients with developmental disabilities (Whittle, Fisher, Reppermund, Lenroot, & Trollor, 2018).
Needs, Competencies and Recommendations
- Communication skills:
- Physicians should be patient-centered;
- patience;
- Use of assistive technology;
- Length of visitation duration:
- Enough time allocation for patient visits;
- Proper understanding of patient needs;
- Training office staff members;
- Patient education:
- Proper patient education is needed;
- Tailored patient education programs based on needs;
- Emotional and physical support needed.
Physicians have a duty to provide quality care to all patients regardless of whether they have developmental disabilities or not. Therefore, some core competencies are needed to enable physicians to render their services competently. Concerning communication barriers, physicians should focus on patient-centered service delivery. As such, despite the efforts and time needed to communicate effectively with patients with developmental disabilities, physicians will be patient enough to ensure that the message is passed across and received by the recipient. Besides, physicians should encourage the use of assistive technology where possible. For instance, patients with hearing or speaking impairments may use technological devices to facilitate their communication with health care providers.
Concerning the length of time that patients have during their visits to care facilities, physicians should exercise patience to ensure that they give enough time for quality care services. Physicians should be competent enough to understand different patient needs. As such, physicians should discuss with patients and implement customized care plans to ensure compliance with treatment and positive outcomes. Besides, physicians should ensure that office staff members are trained on how to handle patients with different needs. For instance, when scheduling for visits, office telephone staff members should identify patients with special needs and allocate sufficient time with the physician. Physician-patient interaction should be healthy and fruitful at all times to facilitate appropriate care provision and positive outcomes.
On patient education, physicians should communicate in a way that allows patients to understand and synthesize information. For instance, if a patient has short attention spans, the physician should give the most important information immediately after their meeting has started. Patients could also be asked to give feedback to ensure that they have understood what has been said. In cases when dealing with individuals with vision problems, colored print or large fonts could be used to facilitate patient educations. Ultimately, physicians should be competent enough to offer the required emotional, physicals, and psychological support that patients need to overcome their health challenges. Family members and friends should be involved where necessary.
Questions to Other Presenters
- Role of healthcare providers in access to care services.
- Role of advocacy in promoting access to care services.
References
Dern, S., & Sappok, T. (2016). Barriers to healthcare for people on the autism spectrum. Advances in Autism, 2(1), 2-11.
McClintock, H. F., Barg, F. K., Katz, S. P., Stineman, M. G., Krueger, A., Colletti, P. M., … Bogner, H. R. (2015). Health care experiences and perceptions among people with and without disabilities. Disability and Health Journal, 9(1), 74-82.
McClintock, H. F., Kurichi, J. E., Barg, F. K., Krueger, A., Colletti, P. M., Wearing, K. A., & Bogner, H. R. (2018). Health care access and quality for persons with disability: Patient and provider recommendations. Disability and Health Journal, 11(3), 382-389.
Roll, A. E. (2018). Health promotion for people with intellectual disabilities – A concept analysis. Scandinavian Journal of Caring Sciences, 32(1), 422-429.
Selick, A., Durbin, J., Casson, I., Lee, J., & Lunsky, Y. (2018). Barriers and facilitators to improving health care for adults with intellectual and developmental disabilities: What do staff tell us? Health Promotion and Chronic Disease Prevention in Canada, 38(10), 349-357.
Whittle, E., Fisher, K., Reppermund, S., Lenroot, R., & Trollor, J. (2018). Barriers and enablers to accessing mental health services for people with intellectual disability: A scoping review. Journal of Mental Health Research in Intellectual Disabilities, 11(1), 69-102.
Williamson, H. J., Contreras, G. M., Rodriguez, E. S., Smith, J. M., & Perkins, E. A. (2017). Health care access for adults with intellectual and developmental disabilities: A scoping review. Occupation, Participation and Health, 37(4), 227-236.