Accessibility for Medical Practices

I can recall a number of times throughout my childhood when my mother and siblings were turned away from receiving medical care simply because they were deaf. Sometimes they would arrive to a scheduled medical appointment where there were just no interpreters or accommodations, or other times they’d be denied the opportunity to even schedule an appointment. The person at the desk would tell my mother that their office wouldn’t accommodate the needs of deaf patients, and perhaps offer a referral to an office located all the way across the city. Not only are these practices totally illegal, but it is a form of oppression, and it unfortunately still happens today.

Despite the Americans With Disabilities Act (ADA) being law for more than 25 years, deaf individuals continue to face difficulties when seeking medical care. In 2014, a woman in Washington State arrived at the hospital for a planned induced delivery only to discover that her request for an interpreter had not been fulfilled. When the delivery became complicated and a cesarian section was necessary, the woman struggled to comprehend what was happening. Less extreme situations commonly go unreported. A deaf person who needs to see a doctor but gets turned away at the desk might get upset and frustrated, then just book an appointment somewhere else— but it would be well within their rights to bring a lawsuit against the doctor’s office for violating Title III of the ADA, which guarantees equal access to privately owned places of public accommodation.

For the most part, medical office staff do not maliciously engage in oppressive behaviors toward deaf patients. The disconnect is typically a general lack of knowledge. It should be a priority for office staff and medical practitioners to understand deafness, as more than 15% of adults in America are living with some level of hearing loss; and more than 25% of people over 65 have disabling hearing loss.

How to Interact with an Individual who is Deaf

To help create positive relationships with deaf patients, medical office staff can familiarize themselves with a few basic communication strategies.

Often, the first frustrating hurdle to medical care occurs when the deaf patient calls the medical office to schedule an appointment and the receptionist hangs up on the relay call, thinking it’s a telemarketing call. Do NOT hang up on relay calls! Receptionists should be trained to recognize a call from a relay service and feel confident engaging with the deaf consumer in this way.

Some deaf people are able to read lips, but it’s not safe to assume anyone’s comfort with this method. Lip reading is generally not a reliable means of communication in a medical setting, unless the deaf individual explicitly indicates that they would prefer to receive their medical information using oral communication. Studies have shown that even the very best lip reader can only capture about 30% of what is being said. Always defer to the patient’s preferences.

If a deaf patient is in the office, notes can be a good way to communicate short, simple ideas. When interacting with a deaf individual, medical staff and providers should have a pen and paper available, or opt for digital using a smartphone or tablet to write back and forth. This can be a great way to ask the deaf person how they prefer to communicate, if they have their insurance card, or when they would like to schedule their next appointment. Notes may be a preferred method of communication for some late-deafened or hard of hearing individuals.

However, for those who use American Sign Language as their primary form of communication, notes are not an effective way to discuss symptoms or deliver a diagnosis, since ASL is a unique language that doesn’t translate directly to English. If a deaf person who uses ASL arrives to the office and an interpreter has not been scheduled, office staff may use notes to communicate regarding the patient’s interpreter preferences and reschedule the appointment. Medical professionals must avoid pressuring deaf patients to proceed without an interpreter, as this can open up a potential liability.

Staff members and medical professionals should remember to keep checking in every step of the way to make sure the patient remains engaged. If one communication strategy doesn’t seem to be working, work together with the patient to create a more effective strategy.

Providing Interpreters

Under the ADA, it is the obligation of the medical service provider as a public entity to offer equal access for all citizens. For those who identify as ASL users, the most reasonable accommodation is usually an interpreter.

Every medical practice, without exception, ought to have a current contract on file with a reputable local interpreting agency. Deaf-owned or interpreter-owned agencies are preferred because they offer higher quality services with a focus on consumer satisfaction. Be prepared! The ADA has been law for more than 25 years so the funds for accessibility services should be allocated into the operating budget; financial hardship is difficult to prove.

When requesting services, it is advised to provide as much information as possible to ensure a good interpreter match. Note that interpreters do book up in advance, so it is ideal to make the request with at least a week’s notice to secure coverage.

Family Members and Staff Members are NOT Interpreters

Utilizing a deaf patient’s family members or medical office staff as interpreters is a HUGE no-no, and a liability lawsuit waiting to happen. Medical interpreters are trained professionals with specialized vocabularies, they navigate both linguistic and cultural barriers using an established code of ethics.

If staff members at the medical office happen to know sign language, they should only utilize it to converse with deaf patients if they are fluent. A person seeking medical care does not necessarily want to help the receptionist practice their ASL. If a staff member is not a licensed interpreter, it is not appropriate for them to provide sign language interpreting services, nor is it appropriate for the family members of deaf patients to provide interpreting services.

Cultural Competency

Cultural competency training offers exciting opportunities for medical providers and support staff to connect with a segment of the population that has for too long been forced to the sidelines when it comes to their own healthcare.

A comprehensive training program led by deaf panelists can provide employees of a medical practice a safe space to work through common misconceptions, break free of stereotypes, and consider new perspectives. As a professional development program, cultural competency training helps employees understand their legal responsibilities, and cultivates a deeper sense of compassion.

For medical providers and employees within the medical care industry, of course people are the first priority. By laying a foundation of cultural understanding, it’s easy to build a successful practice that attracts diverse members of the community, and to earn a positive reputation for accessibility.

SignNexus is pleased to offer Sign Language Interpreting services both on-site and remotely to help medical providers effectively fulfill their obligations under the ADA. Contact us today!