10/20/2020    Leonard A. Levy, DPM, MPH

Compliance by Podiatric Physicians with the ADA

Nearly 40 million Americans are individuals with
disabilities.(1) Since podiatric medical
practices are likely to include patients with
disabilities, it is important that they are
prepared to treat such individuals. Not only do
such patients often experience poorer outcomes,
but the podiatric physician may be unprepared or
uncomfortable treating those with disabilities or
perhaps even overwhelmed at the often-complex
regulations surrounding their care (or perhaps
even unaware that such regulations exist).

The Americans with Disabilities Act (ADA) is a
comprehensive federal civil rights law designed
to ensure equal access and protection for
individuals with disabilities. Under the Act,
medical practices are required to ensure that
their products and services are equally
accessible to patients with qualified
disabilities. Full access to office space, exam
rooms, and medical equipment is included within
this spectrum.

The following indicates accessibility problems
and solutions to meet ADA obligations (a more
comprehensive checklist is available by visiting
www:ada.gov/recheck.pdf):

Accessible approach/entrance:

Is there a route of travel by patients that does
not require the use of stairs?
Is such a route slip-resistant?
Is the route 36 inches wide to accommodate
wheelchairs?
Can objects protruding into the circulation paths
be detected by someone with visual disabilities
using a cane?
Is there an adequate number of parking spaces
available and are there spaces near the
accessible entrances?

Access to goods and services:
Does the accessible entrance provide direct
access to the main floor, lobby, or elevator?
Are accessible routes and doors to all public
spaces at least 36 inches wide to accommodate
wheelchairs?
Is there a 5-foot circle or T-shaped space for a
person in a wheelchair to reverse direction?
Do signs and room numbers have brailled text of
the same information?

Access to restrooms:

Is at least one restroom (one for each sex or
unisex) fully accessible?
Does the restroom have a doorway with at least 32
inches of clear width

Staff training:

Is all staff trained in compliance with
appropriate measures that welcome patients with
disabilities? (Basic disability awareness
training helps staff interact in a relaxed
manner)

The ADA defines disability as “a physical or
mental impairment that substantially limits one
or more major life activities, a person who has a
history or record of such an impairment, or a
person who is perceived by others as having such
an impairment.” Disabilities typically fall into
the following categories:

Physical/mobility impaired
Sensory (e.g., blind, vision-impaired, deaf and
hearing impaired.)
Intellectual/developmental (e.g., Down’s
syndrome, autism spectrum disorder, fetal alcohol
syndrome, etc.)
Mental illness (e.g., schizophrenia, obsessive
compulsive disorder, post-traumatic stress
disorder, etc.)
Chronic illness (e.g., multiple sclerosis,
rheumatoid arthritis, etc.)

The safest way to comply with the ASDA is to
ensure that your website meets applicable Web
Content Accessibility Guidelines (WCAG). More
information about this can be found at:
www.w3.org.WAI/standards-guidelines/wcag.
Failure to take action may result in a complaint
letter and serious legal consequences.

A cottage industry exists that includes attorneys
seeking to sue practices with non-compliant
websites. However, Marsha Saxton, PhD, says, “My
concern about starting with the law is that the
best way to learn and understand accommodating
people with disabilities is through
relationships. When you know people who use
wheelchairs, or have cognitive disabilities or
hearing impairment, the rules make sense in
context of people’s lives. Just focusing on the
law makes people think it’s all about not getting
sued.”

References

MMWR, 2016; 65 (38); 1021-1025.
Margosian E; Caring for patients with
disabilities, Dermatology World. American Academy
of Dermatology; October 2020; 26-31.

Leonard A. Levy, DPM, MPH, Ft. Lauderdale, FL

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