Doctors With Disabilities: Why They’re Important – The New York Times

There’s good reason to believe a more diverse work force — one that includes doctors with disabilities — would be good for patients and doctors. Patients of various backgrounds tend to feel more comfortable with physicians like them, and that’s true for people with disabilities as well.

Source: Doctors With Disabilities: Why They’re Important – The New York Times

More than 20 percent of Americans — nearly 57 million people — live with a disability, including 8 percent of children and 10 percent of nonelderly adults. And while the medical profession is devoted to caring for the ill, often it doesn’t do enough to meet the needs of the disabled.

Read entire article… Doctors With Disabilities- Why They’re Important – NYTimes

 

Dr. Gregory Snyder, a physician at Brigham and Women’s Hospital in Boston, has paralysis in his legs after a spinal cord injury during medical school. He uses a wheelchair and says that he’s sometimes mistaken for a patient while working. But that’s not necessarily a bad thing.

“It reminds us that at some point we’ll all be patients,” he said. “And perhaps, when we least expect it.”

Over the course of our lives, most of us will acquire a disability: More than two thirds of Americans over the age of 80 have a motor, sensory or cognitive impairment.

Dr. Snyder remembers the difficulty of adjusting to life as a patient after his accident, and the long road to recovery. But he says his disability and rehabilitation have fundamentally changed the way he cares for patients — for the better.

“I would have been this six-foot-tall, blond-haired, blue-eyed Caucasian doctor standing at the foot of the bed in a white coat,” he said. “Now I’m a guy in a wheelchair sitting right next to my patients. They know I’ve been in that bed just like they have. And I think that means something.”

There’s good reason to believe a more diverse work force — one that includes doctors with disabilities — would be good for patients and doctors. Patients of various backgrounds tend to feel more comfortable with physicians like them, and that’s true for people with disabilities as well.

Opioid Prescribing: Where you live matters

Source: Opioid Prescribing: Where you live matters

Download Opioid Factsheet

The amount of opioids prescribed in the US peaked in 2010 and then decreased each year through 2015. However, prescribing remains high and vary widely from county to county. Healthcare providers began using opioids in the late 1990s to treat chronic pain (not related to cancer), such as arthritis and back pain. As this continued, more opioid prescriptions were written, for more days per prescription, in higher doses. Taking opioids for longer periods of time or in higher doses increases the risk of addiction, overdose, and death. In 2015, six times more opioids per resident were dispensed in the highest-prescribing counties than in the lowest-prescribing counties. County-level characteristics, such as rural versus urban, income level, and demographics, only explained about a third of the differences. This suggests that people receive different care depending on where they live.  Healthcare providers have an important role in offering safer and more effective pain treatment.

Healthcare providers can:

  • Follow the CDC Guideline for Prescribing Opioids for Chronic Pain, which includes recommendations such as:
    • Use opioids only when benefits are likely to outweigh risks.
    • Start with the lowest effective dose of immediate-release opioids.  For acute pain, prescribe only the number of days that the pain is expected to be severe enough to require opioids.
    • Reassess benefits and risks if considering dose increases.
  • Use state-based prescription drug monitoring programs (PDMPs) which help identify patients at risk of addiction or overdose.

Women with Disabilities Need Better Access to Preventive Cancer Screening

Source: University of New Hampshire, Disability and Public Health Project (NH UCEDD)

In NH, women with disabilities are significantly less likely than the general population to comply with breast and cervical cancer screening recommendations of the U.S. Preventive Services Task Force.  Preventive screenings are especially challenging for women with disabilities due to barriers, such as:

  • Lack of accessible health care facilities and medical equipment; and
  • Health care providers who lack cultural competence with disability and awareness of needed accommodation.

Download Disability & Women’s Health

Adults with Disabilities Need Better Diabetes Prevention Care

Source: University of New Hampshire, Disability and Public Health Project (NH UCEDD)

In New Hampshire, adults with mobility and cognitive limitations are significantly more likely to experience diabetes (26%) than adults with no disability (9%).1 The disparity in diabetes prevalence results in higher costs to Medicaid programs and poorer health outcomes and quality of life for people with disabilities.Several factors contribute to a higher risk of diabetes, including:

  • Unhealthy eating habits that result, in part, from uninformed and limited food choices;

  • Lack of physical activity due to social, environmental, and behavioral barriers; and

  • Lack of knowledge and support to address risk factors for diabetes.2

Download Diabetes Prevention

Include “Low-Tech” Options to Share Health Information with People with Disabilities

Source: University of New Hampshire, Disability and Public Health Project (NH UCEDD)

Adults with disabilities in New Hampshire (NH) are significantly less likely than adults without disabilities to have access to information electronically. This can affect access to:

  • Online communities that encourage healthy behaviors;
  • Electronic health records & appointment reminders;
  • Knowledge & strategies to maintain & improve health.

Download Health Communication Needs

Resources | Protect Our Care IL

Source: Resources | Protect Our Care IL

Protect Our Care – Illinois is a statewide coalition of health care advocates, providers, consumers, and workers, joining together to prevent the repeal of the Affordable Care Act (ACA), prevent disastrous changes to Medicaid, and protect and expand access to quality affordable health care. We know the crusade to undermine the ACA is not over whether there is a repeal vote this week, next week, or next year, so Protect Our Care – Illinois invites you to join Illinoisans across the state to defend access to quality affordable health care for all.

Protect Our Care materials

Knowledge and expectations of direct support professionals towards effects of psychotropic drug use in people with ID

To achieve sufficient collaboration of intellectual disability support professionals in reducing inappropriate psychotropic drug use of clients, vocational educational training is needed.

Source: Knowledge and expectations of direct support professionals towards effects of psychotropic drug use in people with intellectual disabilities – Kuijper – 2017 – Journal of Applied Research in Intellectual Disabilities – Wiley Online Library

Abstract

Background/Introduction

In this study, we investigated intellectual disability support professionals’ knowledge and expectations towards effects of psychotropic drug use on behaviour and drug use in their clients, because shortcomings may lead to misinterpretations of behavioural symptoms and inappropriate drug use.

Methods

Two self-designed questionnaires were used to measure the knowledge and expectations of 194 support professionals in 14 residential facilities regarding psychotropic drug use and effects of antipsychotics on behavioural, cognitive and mental functioning of people with intellectual disability. The psychometric properties of both questionnaires were adequate.

Results

A majority of the professionals had unrealistic expectations regarding the positive effects of antipsychotics on cognitive and behavioural functioning, and 94% scored below the cut-off scores regarding knowledge; 60% indicated they needed education and training.

Conclusions

To achieve sufficient collaboration of intellectual disability support professionals in reducing inappropriate psychotropic drug use of clients, vocational educational training is needed.

Pain and pain assessment in people with ID

Pain and pain assessment in people with intellectual disability: Issues and challenges in practice

Source: Pain and pain assessment in people with intellectual disability: Issues and challenges in practice – Doody – 2017 – British Journal of Learning Disabilities – Wiley Online Library

Accessible summary

  • Pain is difficult to identify when people cannot communicate.
  • If pain is not identified, it cannot be managed and causes stress.
  • Pain assessment is essential in order to identify pain.
  • Pain assessment requires a combination of knowledge, health assessments and observations.

Abstract

Background

Individuals with intellectual disability experience the same chronic diseases and conditions as the general population, but are more likely to have physical and psychological co-morbidities, resulting in a higher risk of experiencing pain and having more frequent or severe pain.

Method

This position paper aims to highlight the importance of pain assessment for people with intellectual disability.

Results

As people with intellectual disability live within the community and/or remain in the family home, they are accessing a wide range of healthcare services. This necessitates that nurses across all care settings are knowledgeable regarding appropriate/alternative pain assessment methods for people with intellectual disability. While many pain assessment tools are available for use with the intellectual disability population, they are often not well established or infrequently used to establish their validity.

Conclusion

Although self-report is the gold standard in pain assessment, pain assessment for people with intellectual disability is often challenging as they may be unable to self-report their pain due to their levels of communication or cognitive ability. Assessment requires a combination of approaches amalgamating: pain assessment, health assessment and observation of behaviours.

The Impact of Health Reform Repeal on Employment

Use this interactive map to see the state-by-state impact of repeal of federal health reform on jobs.

Source: The Impact of Health Reform Repeal on Employment – The Commonwealth Fund

Contrary to a common misconception that health reform law has been a “job killer,” this study shows that repeal of these policies may cause major job losses and economic dislocation in every state -even in states that have not expanded their Medicaid programs.

While health reform repeal would dramatically increase the number of uninsured and harm access to health care, particularly for low- and moderate-income Americans, this analysis demonstrates that the consequences could be broader and extend well beyond the health care system. Repeal could trigger major reductions in employment and substantial losses in state economic activity and state and local revenues.

While health reform repeal would dramatically increase the number of uninsured and harm access to health care, particularly for low- and moderate-income Americans, this analysis demonstrates that the consequences could be broader and extend well beyond the health care system. Repeal could trigger major reductions in employment and substantial losses in state economic activity and state and local revenues.

Hover over states to see the impact of repeal of premium tax credits and Medicaid expansion on jobs.

Or click to download a state profile available under the map.

Impact of Health Reform Repeal-US Map
Impact of Health Reform Repeal-US Map

Daphne Ron: Good and Bad Experiences with Health Care

Watch Daphne Ron’s Presentation Good and Bad Experiences with Health Care

TRANSCRIPT: Daphne Ron Presentation Good and Bad Experiences with Health Care

Self advocate Daphne Ron discusses the good and bad experiences she has had with health care during the “Partnering to Transform Healthcare with People with Disabilities (PATH-PWD) – Improving Acute, Primary and Transitional Health care with People with Disabilities” conference March 23-24, 2017 at Rush University. This conference was a collaboration between Rush and the RRTC-DD and Health which was funded by AHRQ.

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