For more than 50 years, federal disability civil rights laws have mandated that patients with disability receive equitable health care.1 Nevertheless, these laws have not eliminated health care disparities for disabled people. In 2000 federal public health officials recognized this inequity,2 and in 2023 the National Institutes of Health finally designated people with disability as a population experiencing health disparities.3

For more than 25 years, researchers have documented health and health care disparities among persons with diverse disabilities and across health care needs.4,5 Most research has used data gathered directly from people with disabilities, either through surveys or individual or focus group interviews. Therefore, perceptions of disabled people about the barriers impeding their care are well understood and include many obstacles disability civil rights laws explicitly address, such as ineffective communication, inaccessible care settings, and failures to accommodate disability-related needs.1,4 Other problems are less amenable to legal remedies, including ableist attitudes among physicians, their inadequate knowledge about caring for people with disabilities, and financial concerns. For most barriers, physicians play central roles in perpetuating these impediments.

Several years ago, we conducted the first nationwide survey of doctors about their experiences with and perceptions of caring for people with disability.6, 7, 8, 9, 10, 11 Our survey was limited by focusing exclusively on adults and outpatient care within seven medical specialties. To bolster response rates, we kept our survey short and asked few follow-up questions (e.g., about why participants answered as they did). However, as do many surveys,12 we included an open-ended question at the end of the survey, inviting participants to provide additional comments about caring for patients with disability. We anticipated that these open-ended responses would explain participants’ answers to survey questions or raise new issues our short survey did not address.

This brief report summarizes major themes from the open-ended comments at the end of our physician survey. Although many surveys include open-ended questions, ultimately these comments are not analyzed because of “their uncomfortable status … [as] strictly neither qualitative nor quantitative data.”12 However, given persisting health care disparities for people with disability – and physicians' roles in access barriers – even unstructured responses in physicians’ own words could yield clues about mitigating this inequity. Below, the Methods section briefly reviews survey development and administration (details are available elsewhere6, 7, 8, 9, 10, 11) and then describes the open-ended question and analysis of responses. To provide context, the Results section briefly presents the nationally representative survey results (i.e., findings from the close-ended survey questions), most of which are already published,6, 7, 8, 9, 10, 11 followed by related themes arising from the open-ended comments. Appendix A contains the survey.

Given differing preferences about disability language, this paper alternates between person-first (“person with disability”) and identity-first (“disabled person”) language.