Monday, November 13, 2006

Study Finds Discrimination Against Disabled Patients (women)

Multiple Medical Problems Make Breast Cancer Treatments Harder forSome
M.D.Nov.6, 2006- Audrey Robinson, now in her 50s, was a 10-year stroke survivorwhen she was diagnosed with early stage breast cancer. The stroke left Robinson visibly disabled. One side of her body is entirelylimp and motionless. Robinson walks with a complex cane, and uses herworking arm and leg to drag and support her weak side. Although Robinson's disability made her a veteran of the health care system,she was unprepared for the way the breast cancer surgeon treated her. She waited more than four hours to enter an examination room.But even when the doctor did arrive, he didn't treat Robinson with therespect she might have expected. "After making us wait. the door swung open, the doctor swooped in andproceeded to make me feel worthless," Robinson says. "No apologies weremade. He was abrupt, impatient, and never looked me in the eyes. I could'vebeen there with horns on my head and he wouldn't have noticed."I'm not the kind to speak up but I did," she says.Her story came as a real surprise to me - I happen to know the offendingsurgeon and have always known him to be caring and respectful. But, as a newstudy suggests, the surgeon's poor manners might have been related toRobinson's disability. Women with early stage breast cancer who are also disabled are less likelyto be offered today's best treatment options, according to researchpublished in today's Annals of Internal Medicine.For example, lumpectomy (removal of the breast cancer) followed by radiationof the rest of the breast is just as effective a treatment as mastectomy(removal of the whole breast). And a woman who undergoes lumpectomy doesn'tnecessarily lose her breast the way she would from a mastectomy. But women with disabilities were 20 percent less likely to be offeredbreast-saving treatment, according to the study. And the disabled women whounderwent lumpectomy were about 20 percent less likely to be given necessaryradiation after lumpectomy. Every woman's life is precious and deserves the best care possible. So, whydoes this happen? Unfortunately, the research is somewhat true. Patients with multiple medicalissues need a lot of attention in the doctor's office, and doctors tend tobe impatient. It turns out that many complex factors influence these health caredecisions. * Related:<> * Related: Health Problem? <>Concern? Ask Us

Women who are disabled tend to have limited financial resources, insurancecoverage, social networks, transportation options and back-up plans. Adisabled patient may have nowhere to turn in case of bad weather, a brokenwheelchair or a no-show transport team. Disabled patients also tend to have other medical problems and emotionalchallenges that can be almost as threatening and all-consuming as theirbreast cancer. For example, dialysis patients have to juggle hours ofdialysis treatment with their daily radiation therapies.Many of these challenges can make the logistical demands of regulartreatments hard to meet. So what can a woman do?Each woman who faces breast cancer - fully able or disabled - needs to workcarefully with her doctor to figure out her best treatment options againstbreast cancer. While weighing the pros and cons of any treatment option, ask your doctorabout other medical issues.You, as a patient, own your choice. Any given treatment decision may requirespecial arrangements - assisted transportation, coordination with othertherapies like dialysis, etc. It may help to ask for a social serviceconsultation, to find out all of the resources that are available to you. Dr. Marisa Weiss is president and founder of