Who's Calling Who Uppity

In a recent NPR story about the widely-reported research study on how doctors discriminate against patients with disabilities, the senior author of the study, Dr. Lisa Lezzoni of Harvard, herself a wheelchair user, said this about the doctors she interviewed:

“Well, they were talking about how they found patients with disabilities to be entitled, to want accommodations that the physician didn't think that they needed, to come in with kind of an attitude, if you will.”

Despite the fact that none of these doctors had given a moment’s thought about how to accommodate someone with a disability – one suggested sending people in wheelchairs to supermarkets or zoos to check their weight – it’s hard to know if such patients expressed an “attitude” before or after they were sent off to the zoo scales or otherwise turned away. If it was before being rejected, the patient a) was accustomed to being disrespected or denied service or b) was good at inventing Jack Stories, i.e., imagining an awful situation before it happens. Being uppity for a disabled person is clearly a defensive reaction against not being taken seriously, as any sentient being, even a doctor, can plainly see. It’s an understandable response to being viewed as lesser than.

My late mother was a single mom raising four kids in the 1950s, and given the way women were often treated in that era, she was extraordinarily sensitive to being seen as less than a man. And she had an attitude. If a waiter brought her coffee in a restaurant that was lukewarm, he heard her rant and felt the sting of her rage. She took it personally and saw it as an affront to her dignity. Us kids were often embarrassed by her over-the-top indignation. Now that I wander the world in a wheelchair, I get it.

Doctors in this situation are armed with excuses. Out loud: my office is too small, my exam table too high, or we don’t have the right equipment for you. Unspoken: disabled patients take up too much office time because they think they are “special” and simply aren’t worth all the extra treatment and accommodations they demand.

In the NPR interview, Dr. Lezzoni ends with a disturbing observation. Via another, in-depth study, a survey showed that 82% of doctors in America think that people with a disability have a worse quality of life than the non-disabled. Fundamental decency would dictate that physicians would work harder to improve that quality of life. Dr. Lezzoni concludes just the opposite: this might explain, she says, “why doctors don’t bother to get patients out of their wheelchair to do a pap test or recommend a mammogram.” In her view, doctors like these do think less of, or have lower expectations for, patients who are disabled. None, of course, would ever admit as much. It would detract from their caring persona.

Not my own doctors, I don’t think, and hopefully not yours. If you should happen to run into this situation, I recommend standing your ground and raising your voice. The doctor still might reject you because of your bad attitude, but he or she will remember the encounter long after you’ve gone. In baseball, you don’t yell at the umpire in order to get him to reverse the bad call he just made. You yell at him to get him thinking about the next call and hopefully make up for his past mistake.

Try it the next time you encounter a doctor who is mealy-mouthed or simply can’t be bothered. Then sue him for violating the ADA and enjoy that lengthy stay at the White Lotus.