The general practice care of people with intellectual disability: barriers and solutions.
Doctors keep saying they need ID communication training, and hospital data prove the care gap is real.
01Research in Context
What this study did
Smith et al. (1997) mailed a survey to 529 Australian family doctors. They asked what makes it hard to treat patients with intellectual disability.
Doctors listed the top problems and the fixes they wanted. The team tallied the answers to see which barriers came up most.
What they found
Talking with patients topped the list. Doctors said they did not know how to reach someone who spoke little or used signs.
Lack of training came next. Most had never learned how to check pain, give shots, or plan care for this group.
How this fits with other research
The same year, Christian et al. (1997) asked UK doctors the same questions and got the same answers. Both surveys show doctors feel lost when care moves past basic illness.
Later numbers prove the worry is real. Faso et al. (2016) used national visit data and found Australians with ID get far fewer cancer screens and shots. McConkey et al. (2010) added harder proof: people with ID land in hospital for preventable problems six times more often.
Training fixes are still missing. Burack et al. (2004) and Adams et al. (2021) repeat the call for hands-on teaching, showing the gap has not closed in twenty-four years.
Why it matters
Your client may avoid the doctor because past visits felt rushed or scary. Share the survey’s fix list with the GP: schedule longer slots, let you or the family stay, and use picture pain scales. Push for yearly preventive visits; the data show they often don’t happen unless you ask.
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02At a glance
03Original abstract
A questionnaire exploring general practitioners' (GPs') perceptions of the barriers and solutions to providing health care to people with intellectual disability was sent to 912 randomly selected GPs throughout Australia. A response rate of 58% was obtained. Results indicated that numerous barriers compromise the quality of health care able to be provided to people with intellectual disability. Communication difficulties with patients and other health professionals, and problems in obtaining patient histories stood out as the two most significant barriers. A range of other barriers were identified, including GPs' lack of training and experience, patients' poor compliance with management plans, consultation time constraints, difficulties in problem determination, examination difficulties, poor continuity of care, and GPs' inadequate knowledge of the services and resources available. General practitioners also suggested numerous solutions to these barriers, and emphasized the need for increased opportunities for education and training in intellectual disability. The GPs showed an overwhelming willingness to be involved in further education. Other major solutions included increasing consultation duration or frequency, proactively involving families and carers in patients' ongoing health care, and increasing remuneration.
Journal of intellectual disability research : JIDR, 1997 · doi:10.1111/j.1365-2788.1997.tb00725.x