Marji Erikson Warfield et al. 2015. "Physician Perspectives on Providing Primary Medical Care to Adults with Autism Spectrum Disorders (ASD)." Journal of Autism and Developmental Disorders. 45(7):2209-2217
This study JUST came out a few days ago. If anyone would like the full article, just send me a private message and I'll be happy to email it.
10 primary care physicians/family doctors who see autistic adult patients were asked to discuss issues with accommodations these patients. I liked the format of this study because it included block quotes in plain language from the doctors.
I found three major themes in their comments, and all three were interesting to me because I worked in a doctors office many years ago and there are simple workarounds to everything they said.
1) They wished they had a private waiting area for patients who needed such a thing, either for their own comfort or because they were bothering other patients. At the practice where I worked, we had a spare examining room that we used as a quiet area to seat these kinds of people, or sales people. The doctors also sometimes took naps in there.
There is another way to deal with patients who cannot tolerate other patients. You simply schedule them slightly before or slightly after regular office hours.
2) They would sometimes spend way too much time on a single autistic patient, either because they brought someone with them (a spouse or other social advocate) or because the patient just needed a lot of workarounds. For example they might have to talk directly to their patient's dentist on the phone, which isn't a normal thing. There are always special patients like this. The office staff gets to know them and schedules in extra time for the doctor to deal with them. Mr. So-and-so get's space for two office visits instead of one, or Ms. Whatsit get's scheduled right before lunch or at the end of the day in case she runs over. Yes, you'd lose money but there's no way around that.
3) There was no formal training in autism. Younger doctors might have had it mentioned at some point in their school career, but all the doctors said they pretty much had to learn in a "trial by fire" method. The best way to learn about autism is to get to know autistic people. But doctors could easily read a few books and journal articles. They are supposed to have continuing education to remain doctors, in fact. I suspect that this doesn't happen much because most doctors learn to time manage by only doing the minimum. They work about 12 hours a day, usually with about 15 minutes for lunch and no breaks. If they worked less they'd earn less. If someone is truly interested, he or she could read a book on a plane ride, or have an assistant read something for them and highlight the pertinent parts. My point is that if they really wanted to learn, they could.
There was a positive tone to the article and the doctors' comments seemed pretty fair to me. Not glowing, but not insulting either.
05 Jul 2015, 9:04 am
