This year marks the 34th anniversary of the signing of the Americans with Disabilities Act. Yet, I am ashamed to admit that I have no idea how to provide care for patients with disabilities.

As a physician in training, I am challenged to learn every aspect of medicine and demonstrate mastery of what is considered best medical practice. We learn to take patient histories, perform physical examinations, and develop appropriate assessments and plans. We learn to reassure patients and build trust through empathy, open communication, and compassion.

However, after I started working with disabled patients, I realized I didn’t know how to treat them, let alone make them feel comfortable. Medical educators need to do a better job of creating curriculum that adequately prepares physicians to meet the complex needs of disabled patients.

As a Schweitzer Fellow, I worked with blind and visually impaired adults living in a nursing home. In this setting, more than 90% of the residents live with multiple medical conditions, including chronic obstructive pulmonary disease and cardiovascular disease, which are treated with medication. On average, these residents take more than nine medications, administered by the nursing team on site.

Where are the prescribing physicians, you may ask? Well, they are nowhere to be found. Some residents make an effort to visit their primary care physician (PCP), but they often report that they are not treated with respect. Despite efforts to coordinate transportation plans with appropriate accommodations, residents are often asked to reschedule due to unforeseen conflicts when they arrive at their primary care physician’s clinic. When seen by their primary care physician, it is not uncommon for them to have to move around the office or undergo physical examinations without appropriate accommodations, such as a larger examination room to accommodate patients in wheelchairs or adjustable-height examination tables. In one case, I was horrified to hear from a patient that his primary care physician had yelled at him for not following instructions. These experiences are consistent with those described in the literature on the perceptions of health care by disabled patients, who express feeling “frustrated, confused…invisible, or perceived as incompetent.”

The CDC reports that about 61 million American adults live with some form of disability—and the number is growing. According to the World Health Organization, an estimated 1.3 billion people worldwide live with some form of disability. As the population ages, experts predict that more adults will lose their sight and/or hearing. When social and health inequalities are taken into account, the risk of many medical conditions increases significantly for adults with disabilities. What’s more, a study conducted between 2007 and 2019 found that all-cause mortality was nearly twice as high for adults with disabilities compared to those without. As the patient landscape changes and vision deteriorates, we need more programs to educate and equip physicians to provide better care.

To address this gap, the American Medical Association encourages medical schools to create elective rotations that specialize in the care of people with disabilities. My medical school created an elective program for physicians in training to specialize in the care of the disabled community. The curriculum focuses on interdisciplinary communication and provides opportunities for direct contact with patients with disabilities. Students learn about the causes of intellectual/developmental disabilities, gain a patient perspective, and demonstrate clinical skills through an objective, structured clinical examination (OSCE).

Courses like this prepare us to better serve disabled patients and supplement our basic clinical skills. I look forward to taking this course in my final year of training. However, all medical schools should offer more of these types of classes, as well as classes designed specifically for disabled groups. Without them, students are more likely to perform poorly and make inappropriate requests for OSCE placements for disabled patients. Every medical intern should have at least the basics of disability care by the time they graduate.

The disability community is often overlooked. To address this, more physicians should also become advocates for disabled patients. While some medical schools already have a curriculum designed for disabled patients, most American medical schools do not. Medical schools should increase their efforts to educate physicians and physicians-in-training.

Simon Park, PhD, is a third-year medical student at Loyola University Chicago Stritch School of Medicine. He is also a Chicago Area Schweitzer Fellow, a year-long service-learning initiative supported by the Health & Medicine Policy Research Group in which fellows design and implement innovative projects that address the health needs of underserved communities in Chicago.