Why access matters
Audio version, read by a synthetic voice.
Imagine arriving for medical care and finding a flight of stairs. You use a wheelchair and need a step-free route. Someone tells you to leave your chair behind and army-crawl up.
Having a way to force yourself through a barrier does not make that barrier accessible.
Now imagine the ramp or elevator is available only some of the time, even while the clinic remains open. You can get care only when access happens to be available.
Wheelchair users still face barriers like these. Disabilities that are less visible deserve the same commitment to reliable access.
For someone with sensory or communication differences, a waiting room or a phone-only booking system can also block care. Looking calm does not tell us how much effort participation is taking.
In a 2022 international survey, 80% of autistic respondents reported difficulty visiting a primary care doctor, compared with 37% of non-autistic respondents. Barriers were associated with untreated illness, missed screening or referrals, and delayed presentations requiring more extensive treatment or surgery. (Doherty and colleagues)
A large UK study also found higher mortality among people diagnosed as autistic, with and without intellectual disability. It could not establish how much of that difference came from inaccessible care, and its findings do not predict any one person’s lifespan. (O’Nions and colleagues)
The World Health Organization identifies barriers within healthcare as contributors to preventable health inequities affecting disabled people. (WHO report)
As a pediatrician, I want us to take those findings seriously in how we design care.
An invisible disability deserves access without a person having to become visibly distressed before we respond. Needs may vary across days and settings. Support should respond to those needs, without making people prove them again at every visit.
We can begin in three places:
Environment. Offer a quieter place to wait and ways to adjust light, sound, and movement.
Communication. Offer written or visual information, time to process, and ways to communicate beyond speech.
Workflow. Make booking and follow-up usable, record what helps with permission, and carry that plan across staff and visits.
The Access Room is an invitation to notice what helps you participate and consider what your patients may need.
What is one barrier you could remove and make sure stays removed?
More ways to participate. For every body.
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