Accessibility of Medical Diagnostic Equipment for Patients With Disability: Observations From Physicians

Published:March 25, 2019DOI:



      To explore attitudes and practices of physicians relating to accessible medical diagnostic equipment in serving patients with mobility disability.


      Open-ended individual telephone interviews, which reached data saturation. Interview recordings were transcribed verbatim for qualitative conventional content analysis.


      Massachusetts, the United States, October 2017-January 2018.


      Practicing physicians from 5 clinical specialties (N=20).


      Not applicable.

      Main Outcome Measures

      Common themes concerning physical accessibility.


      Mean ± SD time in practice was 27.5±12.5 years; 14 practices had height-adjustable examination tables; and 7 had wheelchair-accessible weight scales. The analysis identified 6 broad themes: height-adjustable examination tables have advantages; height-adjustable examination tables have drawbacks; transferring patients onto examination tables is challenging; rationale for examining patients in their wheelchairs; perceptions of wheelchair-accessible weight scales; and barriers and facilitators to improving physical accessibility. Major barriers identified by participants included costs of equipment, limited space, and inadequate payment for extra time required to care for persons with disability. Even physicians with accessible examination tables sometimes examined patients seated in their wheelchairs.


      Even if physicians have accessible equipment, they do not always use it in examining patients with disability. Future efforts will need to consider ways to eliminate these access barriers in clinical practice. Given small sample size, results are not generalizable to physicians nationwide and globally.


      List of abbreviations:

      ADA (Americans with Disabilities Act), OB/GYN (obstetrics and gynecology)
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        • Peacock G.
        • Iezzoni L.I.
        • Harkin T.R.
        Health care for Americans with disabilities—25 years after the ADA.
        N Engl J Med. 2015; 373: 892-893
        • Centers for Disease Control and Prevention, US Department of Health and Human Services
        Disability impacts all of us: a snapshot of disability in the United States.
        (Available at:)
        • Iezzoni L.I.
        Eliminating health and health care disparities among the growing population of people with disabilities.
        Health Aff. 2011; 30: 1947-1954
        • Iezzoni L.I.
        • Kurtz S.G.
        • Rao S.R.
        Trends in U.S. adult chronic disability rates over time.
        Disabil Health J. 2014; 7: 402-412
        • Morrison E.H.
        • George V.
        • Mosqueda L.
        Primary care for adults with physical disabilities: perceptions from consumer and provider focus groups.
        Fam Med. 2008; 40: 645-651
        • Iezzoni L.I.
        • Kilbridge K.
        • Park E.R.
        Physical access barriers to care for diagnosis and treatment of breast cancer among women with mobility impairments.
        Oncol Nurs Forum. 2010; 37: 711-717
        • Iezzoni L.I.
        • Wint A.J.
        • Smeltzer S.C.
        • Ecker J.L.
        Physical accessibility of routine prenatal care for women with mobility disability.
        J Womens Health (Larchmt). 2015; 24: 1006-1012
        • Story M.F.
        • Schwier E.
        • Kailes J.I.
        Perspectives of patients with disabilities on the accessibility of medical equipment: examination tables, imaging equipment, medical chairs, and weight scales.
        Disabil Health J. 2009; 2: 169-179.e1
        • Harrington A.L.
        • Hirsch M.A.
        • Hammond F.M.
        • Norton H.J.
        • Bockenek W.L.
        Assessment of primary care services and perceived barriers to care in persons with disabilities.
        Am J Phys Med Rehabil. 2009; 88: 852-863
        • Pharr J.R.
        Accommodations for patients with disabilities in primary care: a mixed methods study of practice administrators.
        Glob J Health Sci. 2013; 6: 23-32
        • Mele N.
        • Archer J.
        • Pusch B.D.
        Access to breast cancer screening services for women with disabilities.
        J Obstet Gynecol Neonatal Nurs. 2005; 34: 453-464
        • Grabois E.W.
        • Nosek M.A.
        • Rossi C.D.
        Accessibility of primary care physicians’ offices for people with disabilities. An analysis of compliance with the Americans With Disabilities Act.
        Arch Fam Med. 1999; 8: 44-51
        • Lagu T.
        • Hannon N.S.
        • Rothberg M.B.
        • et al.
        Access to subspecialty care for patients with mobility impairment: a survey.
        Ann Intern Med. 2013; 158: 441-446
        • Maragh-Bass A.C.
        • Griffin J.M.
        • Phelan S.
        • Finney Rutten L.J.
        • Morris M.A.
        Healthcare provider perceptions of accessible exam tables in primary care: implementation and benefits to patients with and without disabilities.
        Disabil Health J. 2018; 11: 155-160
        • Larson-McNeal M.A.
        • Carrothers L.
        • Premo B.
        Providing primary health care for people with physical disabilities: a survey of California physicians.
        Cent Disabil Issues Heal Prof West Univ Heal Sci. 2002; : 1-16
        • Iezzoni L.I.
        • O’Day B.
        More than ramps: a guide to improving health care quality and access for people with disabilities.
        Oxford University Press, New York2006
        • Lid I.M.
        Universal design and disability: an interdisciplinary perspective.
        Disabil Rehabil. 2014; 36: 1344-1349
        • Iezzoni L.I.
        • Park E.R.
        • Kilbridge K.L.
        Implications of mobility impairment on the diagnosis and treatment of breast cancer.
        J Womens Health (Larchmt). 2011; 20: 45-52
        • Iezzoni L.I.
        • Matulewicz H.
        • Marsella S.A.
        • Warsett K.S.
        • Heaphy D.
        • Donelan K.
        Collaborative design of a health care experience survey for persons with disability.
        Disabil Health J. 2017; 10: 231-239
        • Hsieh H.-F.
        • Shannon S.E.
        Three approaches to qualitative content analysis.
        Qual Health Res. 2005; 15: 1277-1288
        • Sandelowski M.
        Focus on research methods: whatever happened to qualitative description?.
        Res Nurs Heal. 2000; 23: 334-340
        • Sandelowski M.
        What’s in a name? qualitative description revisited.
        Res Nurs Heal. 2010; 33: 77-84
        • Vouchilas G.
        Contemporary living: bringing a universal design principle into the mix.
        J Fam Consum Sci. 2017; 109: 21
        • Kirschner K.L.
        • Breslin M Lou
        • Iezzoni L.I.
        Structural impairments that limit access to health care for patients with disabilities.
        JAMA. 2007; 297: 1121-1125
        • Frost K.L.
        • Bertocci G.
        • Stillman M.D.
        • Smalley C.
        • Williams S.
        Accessibility of outpatient healthcare providers for wheelchair users: pilot study.
        J Rehabil Res Dev. 2015; 52: 653-662
        • Flentje K.
        • Knight C.
        • Stromfeldt I.
        • Chakrabarti A.
        • Friedman N.D.
        Recording patient body weight in hospitals: are we doing well enough?.
        Intern Med J. 2018; 48: 124-128
        • Architectural and Transportation Barriers Compliance Board
        Standards for accessible medical diagnostic equipment.
        Fed Regist. 2017; 82: 2810-2848
        • Mudrick N.R.
        • Breslin M Lou
        • Liang M.
        • Yee S.
        Physical accessibility in primary health care settings: results from California on-site reviews.
        Disabil Health J. 2012; 5: 159-167
        • Sanchez J.
        • Byfield G.
        • Brown T.T.
        • LaFavor K.
        • Murphy D.
        • Laud P.
        Perceived accessibility versus actual physical accessibility of healthcare facilities.
        Rehabil Nurs J. 2000; 25: 6-9
        • Brophy M.O.
        • Achimore L.
        • Moore-Dawson J.
        Reducing incidence of low-back injuries reduces cost.
        J Occup Environ Hyg. 2001; 62: 508-511
        • US Access Board
        Medical diagnostic equipment in the market.
        (Available at:)
        • Cornell Law School Legal Information Institute
        Expenditures to provide access to disabled individuals.
        (Available at:)
        • Centers for Medicare and Medicaid Services, US Department of Health and Human Services
        Medicare program; revisions to payment policies under the physician fee schedule and other revisions to Part B for CY 2018; Medicare shared savings program requirements; and Medicare diabetes prevention program. Final rule.
        Fed Regist. 2017; 82: 53079