Women’s Clinic Specializes In Patients With Disabilities
PITTSBURGH — Joycelyn Banks gets off the lift of the accessible van. She maneuvers her way into the hospital lobby, onto an elevator and gets off at her floor.
Banks enters the doctor’s office, where she’s greeted by registered nurse Jennifer Stephens. The two enter the patient room.
Banks gets onto an examination table — from her motorized wheelchair.
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Banks, 43, from Mt. Washington, has cerebral palsy. She’s arrived for her annual gynecological visit.
Being in a wheelchair requires extra space to navigate. She needs assistance transferring onto a table and requires help keeping her legs stable.
An annual visit to a gynecologist is stressful enough for women, but for those with a physical or intellectual disability, there can be added worries, said Dr. John A. Harris, director of the Center for Women with Disabilities at UPMC Magee-Womens Hospital in Oakland.
It is one of a handful of centers in the country that offers specialty gynecology appointments for women with mobility issues and other challenges. There are others in New York and in Boston.
The clinic has scales for weighing women in wheelchairs, accessible exam tables, patient lifts, and padded hydraulic stirrups.
“This is my hospital,” said Banks, a classroom monitor for the Learning Hub at Allegheny Center Alliance Church on Pittsburgh’s North Side. “They listen to me. They explain everything to me. They work well with each other.”
The clinic offers expertise with preventive care, birth control, a pap test, menstrual problems, post-menopausal bleeding, pelvic pain, sexually transmitted diseases and vaginitis. The medical team works with radiology and breast imaging departments to coordinate care for mammograms and related services, so women can get a mammogram while seated.
“Everything is personalized for the patient,” said Stephens, the lead nurse in the clinic. “We know our patients. We are ready for different situations.”
Things most females take for granted such as stepping on a scale can be major hurdles for those who can’t walk or stand, or who use an assistance device or who might have a learning deficiency, Harris said. An annual one-hour appointment can include days of worry and angst.
“Women with disabilities have the same woman-specific health care needs as all women,” said Harris. “Those needs often are neglected.”
The proper equipment
The clinic was designed in consultation with women with disabilities, and who might not have control over their lower extremities because of multiple sclerosis, cerebral palsy or some form of paralysis. The equipment has larger foot rests, a Hoyer lift to raise a person onto a table, and transfer boards so a patient can slide from a wheelchair to a bed.
Two staff members provide medical help, and might also hold a patient’s hand, sing with her, or just listen.
The first step is earning the trust of patients, said Harris. Some have suffered through embarrassing moments at other places, he said.
Barb Zablotney, 34, from Windber, said at a previous doctor’s office she felt “dehumanized.”
Zablotney, who was injured in a car accident in 2007, is Ms. Wheelchair Pennsylvania president and holder of the 2018 Ms. Wheelchair Pennsylvania title.
The organization’s mission is to educate the public, business community and legislature about issues that are important to people with disabilities, according to its website.
“My doctor was clueless about someone with paralysis,” Zablotney said. “At Magee, they treat you with respect. They actually listened to me.”
Lending an ear
Listening is important, said Paul Friday, chief of psychology for UPMC Shadyside. He said you can have all the services in the world, but what is important is how the patient views those services. If you highlight a disability it might make a woman feel bad. Or, she might be grateful there is a clinic designed specifically for her, said Friday.
“You have to be aware of how something is explained and implemented, because that is crucial,” Friday said. “If you view the process for the exam from the point of view of the patient, then everyone will win. You have to take a step back and see it from the patient’s eyes.”
Changing with the times
Harris said not being able to see his face because of a mask can be intimidating, especially for those with intellectual challenges, so individualized care is even more important during the pandemic. He said he’s working to continue the legacy of Dr. Sandra Welner, a physician who started the clinic in 2001 after she acquired a disability following an illness. She designed tables used at the clinic. She died in a fire, unable to escape because of limited mobility.
“We are focused on meeting each person’s individualized challenges,” Harris said. “I tell a patient what I will do before I do it. The patient may not be able to feel what I am doing, so I want to make sure I explain it. They are the experts of their bodies.”
Most health care exams are stressful, said Nancy Horton, information specialist for the Mid-Atlantic ADA Center, which provides information, guidance and training on the Americans with Disabilities Act, based in Maryland. “It’s important to make people feel more comfortable in stressful situations. Women, and men, with disabilities face challenges and barriers in getting good care.”
Horton said just like you need a specialist for certain physical conditions, having a specialist like this clinic is “really wonderful.”
“It’s about being respectful of a patient with a disability,” Horton said. “Sometimes you might have a person with multiple disabilities. That can present a challenge, but if you have someone caring for you who is sensitive to all of those issues it really helps.”
It really does, agreed Banks.
“I am not going anywhere else,” Banks said. “What is special about Magee, is the team and the equipment, and, well, everything. This is where I feel most comfortable.”
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