Physician experiences providing primary care to people with disabilities

The 2003 Statistics Canada Health Services Access Survey found that 12% of Canadians polled did not have a family doctor, and 18% reported access problems such as long waiting times and difficulty contacting the doctor. Research has repeatedly shown that where a problem with access exists in the general population, it is considerably more severe in subsets of the population that are most disadvantaged. Statistics at both the national and local levels confirm that although people with disabilities have greater need for health services, including both institutional and community services, they also experience significant disadvantages in attempting to access service. The question explored in this study is how physicians' perceptions of disabled patients and behaviour towards them might affect access to primary care for adults with disabilities. The study used a qualitative interpretive approach to uncover physicians' perspectives on working with people with disabilities. Semi-structured interviews were conducted with a sample of 34 physicians in Eastern Ontario. Physicians were asked: How are disabled patients similar to/different from non-disabled patients? How are you as a physician different with disabled patients? Physicians' perceptions, as revealed by their responses to these questions, were interpreted in terms of four types of barriers to access to primary care for disabled adults: physical, attitudinal, expertise-related and systemic. These barriers were examined for their impact on finding a doctor, getting an appointment, getting into the office and receiving a reasonable standard of care.