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Tag: effective communication

  • The Mindset Shift I Teach at Harvard to Create Captivating Presentations

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    There’s a big difference between a person delivering a PowerPoint and someone who’s telling a story. Storytellers captivate and engage audiences. Presenters put people to sleep with boring, confusing, and convoluted slide decks. 

    Be a storyteller, not a presenter. 

    That’s the advice I give to entrepreneurs and business leaders in my Harvard classes on 

    communication skills. The first question they always ask is: “Does that mean we avoid using PowerPoint?” Absolutely not. You can and should use PowerPoint and other graphic design tools to complement your story, but you’ll be far more effective if you build the story first. 

    It might sound like a subtle shift, but once you adopt the mindset of a storyteller, the presentation your audience sees will change for the better. 

    Storytellers storyboard. Presenters build slides. 

    Most people have access to new and cool presentation tools such as AI-generated animations, sleek graphics, and even new PowerPoint features like “designer” that make it easier than ever to generate design ideas. Although the tools are great and will help build better looking slides, they won’t necessarily make your presentations memorable. 

    While it’s tempting to open PowerPoint and start dropping in slides and inserting graphics, the most effective speakers do something different: They storyboard first. Storyboarding simply means laying out the flow of your message before you touch the software. Think of yourself as a movie director who sketches out the scenes before picking up a camera.   

    One of my favorite photos that I show in class is a picture of me and SanDisk founder and CEO Eli Harari standing in front of a whiteboard. We were sketching out ideas and creating the flow of the presentation that senior executives would deliver at the company’s annual analyst meeting. Once we could see the big picture and identify key messages, we began to invite designers and creators into the meetings to help us visualize the ideas. While most people rush to open PowerPoint. Great communicators reach for a pen. 

    Storytellers follow structure. Presenters wing it. 

    The reason most audiences find PowerPoints boring is because they lack structure. Presenters build PowerPoint decks while storytellers build arcs. An arc is a journey taken by a character in a book or movie. Think about the arc you want your presentation to take. 

    For example, a simple storytelling structure used in nearly every Hollywood movie is the three-act play. Act 1 is the set-up where the audience gets to know the characters, their world, and what they hope to achieve. Act 2 is the challenge the characters and heroes face. Lastly, Act 3 is the resolution where everything gets wrapped up in a bow. 

    A good business presentation follows a similar arc: 

    • They use Act 1 to describe the world as it exists today for potential customers and prospects. 
    • Then, in Act 2, they define the problems people face in navigating the world as it exists. 
    • Act 3 offers a solution to the problems and a clear call to action. 

    Presenters deliver information. Storytellers guide their audience on a journey. 

    Storytellers rehearse. Presenters read. 

    One of the biggest differences between an average presentation and a truly memorable one happens before anyone steps on stage. Presenters spend their final tweaking slides, adjusting fonts, inserting charts, adding more text and data. Storytellers, on the other hand, spend more time rehearsing for the performance, their opportunity to share their ideas on stage. 

    If you don’t internalize the message you want to convey, you’ll be forced to read from slides or the notes you’ve written on your smartphone. You’ll have missed the chance to move people, to connect with your audience face-to-face and eye-to-eye. Presenters read to the audience. Storytellers speak to the audience, and they can feel the difference. 

    PowerPoint isn’t the enemy. The problem is starting with slides instead of a story. Don’t be the person who delivers a presentation. Be the person who tells a story people will remember. 

    The opinions expressed here by Inc.com columnists are their own, not those of Inc.com.

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    Carmine Gallo

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  • Effective Communication in a Relationship: 5 Ways to Communicate Better

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    In intimate relationships, effective communication serves as the foundation that keeps partners in sync. By mastering the art of communication, couples can navigate challenges with ease, fostering deeper connections and mutual understanding. 

    In this article, we’ll explore five tips that will help you communicate better in your relationship:

    1. Understanding the Importance of Effective Communication in Relationships
    2. Strategies for Positive Communication
    3. Navigating Communication Issues
    4. Conflict Management through Better Communication
    5. The Impact of Non-verbal Communication

    Understanding the Importance of Effective Communication in Relationships

    Effective communication forms the backbone of a healthy relationship. Without strong communication, relationships often struggle to grow and thrive. Partners who engage in positive communication behaviors can enhance their connection, fostering trust and mutual understanding.

    The Role of Communication

    It is through communication that partners share their feelings, hopes, and dreams, allowing them to create a shared vision for their future. The communication style adopted within a relationship can significantly impact how partners relate to one another. Effective communication skills lead to meaningful exchanges that ensure both partners feel heard and understood, while lack of open dialogue may lead to misunderstandings and unmet needs, ultimately affecting relationship satisfaction. 

    By placing an emphasis on healthy communication behaviors, partners are better equipped to manage conflicts, make joint decisions, and strengthen their emotional bond, leading to greater overall satisfaction within the relationship.

    How Communication Strengthens Bonds

    Strong communication acts as the glue that holds relationships together, providing a solid platform for growth and intimacy. 

    Engaging in open dialogues about needs and desires helps partners form a clear understanding of each other, ensuring that both are aligned in their goals and expectations. This mutual understanding nurtures a relationship where individuals feel valued and respected, ultimately boosting relationship satisfaction. Constructive communication behaviors, such as expressing gratitude and offering reassurance, further solidify these bonds.

    Communication also fosters emotional intimacy by inviting partners to share their vulnerabilities and support each other through various challenges. This transparency develops a deeper connection and greater empathy between partners, which are crucial for long-term relationship success.

    Strategies for Positive Communication

    By focusing on techniques that prioritize understanding and mutual respect, partners can develop healthy communication skills that enhance their bond. 

    Techniques for Effective Dialogue

    Effective dialogue in a relationship hinges on the ability to truly listen and communicate feelings with authenticity. The following techniques can help you and your partner really listen, understand each other better, and see each other’s point of view.

    Active Listening

    Active listening requires partners to engage with their whole selves, focusing on their partner’s words, tone, and non-verbal cues. This means setting aside distractions and dedicating full attention when your partner is speaking, demonstrating that their thoughts and feelings are valued. Listen to understand, not to respond, and don’t try to interrupt or give advice unless it’s asked for or encouraged.

    Mindful Messaging

    Effective communication also involves being mindful of how messages are conveyed. The verbal content of a conversation is just one part of the communication process. Emphasizing clarity, empathy, and a supportive tone helps avoid misunderstandings and ensures that each partner’s intentions are comprehended. 

    Taking Turns

    Have you ever gotten into an argument with your partner where you talk over each other, focus on what you’ll say next instead of listening, or feel like you’re on opposing sides? These types of discussions aren’t productive, and you’re more likely to end up dissatisfied and more upset than you started.

    Taking turns in the dialogue, allowing each person to express themselves fully without interruption, promotes a balanced communication flow. 

    Here’s a Gottman exercise for using a speaker/listener approach:

    • Step 1: Choose a Situation – what are you going to discuss?
    • Step 2: Decide on Roles – who will be the speaker and who will be the listener?
    • Step 3: Explain Your Point of View – the speaker uses“I” statements to explain their point of view, the listener listens to understand, validates, and does not speak about their point of view (yet).
    • Step 4: Listen, Understand, Repeat Back – the listener validates and demonstrates understanding. If further clarification is needed, the speaker can repeat their feelings.
    • Step 5: Validation and Compromise – if a compromise is necessary, it’s discussed at this time.
    • Step 6: Switch Roles – the speaker and listener swap roles and repeat steps 3-5. 
    • Step 7: End with an Appreciation – end on a positive note and tell each other what you love and appreciate about each other. 

    “I” Statements

    In scenarios where emotions run high, using “I” statements can prevent blame and foster a more constructive exchange. “I feel _____ about ______, and I need _______.” is a good place to start. This approach encourages partners to consider the impact of their words on their significant other, enhancing the satisfaction gained from positive communication.

    The more these skills are practiced, the more naturally they become a part of daily interactions, leading to a stronger, more resilient partnership.

    Building Trust through Communication

    Open and honest exchanges lay the groundwork for a relationship where both partners feel secure and valued. 

    Being Truthful

    Trust in communication involves consistently being truthful and transparent about one’s feelings, needs, and thoughts. This openness allows partners to understand each other’s vulnerabilities and fosters an environment where trust thrives. Actively addressing any concerns or doubts in a timely manner also reinforces trust, as it shows a commitment to maintaining the relationship’s integrity and satisfaction.

    Expressing Empathy

    Beyond truthfulness, showing empathy and understanding during exchanges helps deepen the trust partners have in each other. It involves listening with the intent to understand rather than immediately respond. When partners can articulate their thoughts and feelings without fear of judgment or misunderstanding, it contributes significantly to the development of mutual trust. 

    Being Reliable 

    Trust is further built when partners honor commitments and follow through on what has been discussed, proving reliability and reinforcing the belief that both parties are aligned in their relationship goals. To sum it up: say what you mean, mean what you say, and follow through on what you say you’re going to do.

    Respecting Differences

    Additionally, trust grows when partners recognize and respect each other’s communication style. This means accommodating each other’s preferences for sharing and expressing, whether they lean towards verbal exchanges or more subtle, non-verbal cues. Respecting these differences shows a willingness to adapt, an understanding that strengthens interpersonal trust. 

    By embedding these practices into regular communication, partners create a resilient partnership marked by honesty and unwavering trust. Such a relationship is equipped to face challenges with confidence and unity, valuing each interaction as a building block of their shared life.

    Navigating Communication Issues

    Strengthening relationship satisfaction involves understanding and transforming negative communication behaviors into opportunities for growth. By addressing these issues early, partners can prevent misunderstandings and conflicts, ensuring their relationship remains harmonious and resilient.

    Identifying Common Communication Barriers

    Recognizing common communication barriers is the first step towards effective relationship management. Often, feelings of being misunderstood or neglected stem from poor listening practices or a mismatch in communication styles. It’s normal for partners to have varied communication preferences, which can act as barriers if not addressed. Here are some common barriers:

    Passive Communication

    Passive communication, where one’s needs and desires aren’t explicitly stated, often results in misunderstandings, as partners might not fully comprehend each other’s feelings or intentions. This passive style can lead to an environment where emotions simmer but aren’t shared openly, eventually affecting relationship satisfaction and increasing the potential for conflict.

    Misreading Non-verbal Communication

    Additionally, non-verbal communication plays a significant role in how messages are interpreted. Misreading body language, facial expressions, or tone can amplify communication issues. For example, a sigh might be misinterpreted as annoyance when it’s actually signaling fatigue. Understanding these subtle cues and addressing them can minimize potential barriers that prevent effective communication. 

    Assumptions

    Barriers like preconceived notions about a partner’s intentions can cloud judgment. If these assumptions go unchallenged, they can develop into longstanding communication problems that hamper relationship growth. Prioritizing open dialogue and seeking clarity instead of relying on assumptions supports healthier relationships.

    Stress and External Pressure

    Barriers such as stress and external pressures can impact how partners communicate. When life becomes overwhelming, it can hinder one’s ability to engage fully in their relationship, leading to unintentional neglect of their partner’s needs. Recognizing these signs and fostering a supportive environment for discussing external stressors is vital. 

    By actively identifying these communication barriers, partners can work together to dismantle them, ensuring a stronger and more resilient relationship.

    Overcoming Communication Challenges

    Overcoming communication challenges requires persistent effort and a willingness to adapt. 

    Listening to Understand, Not to Respond

    Effective communication starts with practicing active listening, where partners focus entirely on what the other person is saying, avoiding interruptions and demonstrating genuine interest. This lays the groundwork for a more productive dialogue and reduces the likelihood of misunderstandings.

    Using “I” Statements

    Utilizing “I” statements instead of “you” accusations can prevent blame and foster a more understanding conversation. For example, saying, “I feel neglected when we don’t spend time together” is more constructive than saying, “You never spend time with me.” This approach helps diffuse tension and opens up the floor for a more meaningful exchange. 

    Acknowledge Stress

    It’s essential to acknowledge the impact of stress on communication patterns. When partners are under pressure, communication can become strained. Setting aside time to address the sources of stress together can enhance communication by aligning goals and expectations.

    Practicing Patience and Empathy

    Working towards patience and empathy ensures that both partners feel heard and valued. Patience allows partners to navigate conflicts without escalating them. Approaching conversations with empathy fosters a safe space where each partner can express their perspectives without fear of judgment. 

    Overcoming communication challenges is an ongoing process that strengthens a relationship over time, ultimately leading to increased relationship satisfaction. 

    Conflict Management Through Better Communication

    Conflicts are an inevitable part of any relationship, but how partners handle them sets the tone for trust and mutual understanding. Effective communication plays a vital role in resolving these conflicts constructively.

    Approaches to Conflict Management

    In any relationship, the approaches taken to resolve conflicts can significantly affect overall satisfaction and trust. 

    Listening to Understand

    When you listen to understand, you acknowledge individual feelings but also promote a constructive dialogue where both parties feel valued. Active listening is foundational for ensuring misunderstandings are promptly addressed and not allowed to fester into larger issues. Practice active listening by reflecting back what your partner is saying to ensure understanding.

    Softened Start-up

    Another critical approach is embracing the “soft start-up” method, a technique that encourages partners to express their feelings and concerns gently rather than confrontationally. This involves using “I” statements to express emotions softly, preventing partner defensiveness and allowing deeper emotional expression. For instance, saying “I feel overwhelmed when plans are last-minute,” instead of accusatory statements, helps keep the conversation constructive. This method can significantly reduce the intensity of conflicts, steering dialogues towards solutions that both partners can agree on without damaging the trust and respect built over time.

    Regular Check-ins

    Setting aside dedicated time to discuss conflicts when emotions are calmer can be beneficial. Often, addressing issues impulsively during heated moments leads to less effective communication and more conflicts. If things get too heated, choosing a time when both partners are open to dialogue enhances the chances of a productive outcome. It’s about creating a safe environment where both feel comfortable expressing themselves, ultimately leading to healthier and more respectful conflict resolution.

    Implementing these techniques can further contribute to a healthier and more resilient relationship dynamic.

    The Impact of Non-Verbal Communication

    Non-verbal communication plays a crucial role in how partners perceive and interact with each other. While verbal exchanges often get the spotlight, it’s the non-verbal cues, facial expressions, gestures, and body language that convey a wealth of unspoken emotions. Understanding these subtle signals is essential for fostering relationship satisfaction as they often reveal deeper layers of emotions that words alone can’t articulate.

    Interpreting Non-verbal Cues

    A gentle touch or reassuring look can express empathy and understanding, helping partners feel seen and supported. Nonverbal communication is a powerful, silent language that enriches what words convey, especially during conflict, when emotions run high and words can be misunderstood. Learning to read and respond to each other’s nonverbal cues allows couples to navigate difficult moments with greater care and connection.

    Listen to What’s Not Being Said

    Refining one’s ability to listen not just to words but also to what’s unsaid elevates relationship communication. For example, what is your partner really saying when they tell you, “I wanted to stay at the party longer.”? Perhaps they are saying that they were having a good time, they had more they wanted to chat with people about, or they wanted to make sure they didn’t miss something important. By tuning into these unspoken words, partners can learn to better understand each other.

    Effective communication is the foundation of a strong relationship. By practicing active listening, showing empathy, using ‘I’ statements, and paying attention to both words and nonverbal cues, partners can avoid misunderstandings and build deeper trust. It takes ongoing effort from both sides, but the reward is a healthier, more connected relationship that lasts.

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    The Gottman Institute

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  • Strategic Searching: Effective Methods for Finding CEO Contacts – Southwest Journal

    Strategic Searching: Effective Methods for Finding CEO Contacts – Southwest Journal

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    Having direct access to top bosses can help you out these days.

    CEOs are key players who steer their companies and make big choices. They also build important connections that lead to chances for partnerships.

    But it’s not always easy finding the right info to reach these super busy and private people. They’ve got a lot on their plates.

    That’s why we need some smart tactics and helpful resources to unearth their contact specifics. If you are looking for a way to do so, check SignalHire.

    Digging those up is gold, as it clears a path for valuable networking.

    Key Takeaways

    • Sales intelligence tools and manual searches both effectively uncover CEO contacts for those willing to invest effort. 
    • Personalizing outreach to align with a CEO’s background and responsibilities boosts message impact. 
    • Understanding a company’s tech stack and leadership’s buying behavior helps sales reps identify key needs or challenges.

    Tools and Techniques for Finding CEO Contact Information

    First, let us go through different techniques and tools you can utilize to find CEO contract information.

    Using Software and Databases

    Using Software and Databases

    B2B sales have really changed over the years. Now there are way more people involved in each sale than before.

    That’s why using smart tools is so important when trying to reach top business leaders. Things like databases with CEO contact info can help, but they have some downsides too.

    Providers like Prospect IQ offer lists that include emails and numbers for bosses. But the contact details might be out of date or incomplete. And you gotta pay subscription fees to use these resources long-term.

    Email verifiers are helpful additions that double-check if addresses are still good before you message someone. Services like MailTester and ZeroBounce make sure your important messages get through.

    CEOs want to limit spam, so keeping information locked down tight is smart on their part. That’s why validation tools are crucial nowadays. They help you reach key people without cluttering inboxes or wasting your efforts.

    Manual Search Strategies

    Even with all the new tech tools, old-fashioned searching still has merits when trying to reach important business leaders.

    Manual methods take more time but don’t cost money like databases. Tactics include signing up for company emails, investigating partner businesses, and maximizing Google’s search powers.

    Other low-tech options are directly messaging companies, carefully reading press releases, and connecting through LinkedIn. The personal contact shows CEOs you put in real effort.

    Of course, manual hunting demands patience and an eye for detail. You need to dig deep online and through sources to find each helpful clue. Then reach out with a friendly, customized message that shows why connecting is worth their time.

    It’s okay if manual methods move more slowly. What matters is showing decision-makers you care about understanding their business better.

    Sales Intelligence Tools

    Sales Intelligence ToolsSales Intelligence Tools
    This Image Is Generated by Midjourney

    Technology has really changed how sales reps do their jobs these days, especially when trying to link up with top business leaders, like Magic Johnson.

    Programs like SalesIntel and LeadIQ provide sales teams with tons of useful information, far more than just basic contact info. These platforms dig deep into companies and the executives running them.

    They uncover details that were difficult or impossible to find before now. Salespeople gain insights into things like a CEO’s interests, past projects, and current priorities. This type of rich data helps reps start discussions on a much more personal level.

    Where manual searching and basic databases only offer surface facts, these new intelligence tools shine a light in the hidden places. They give reps a true advantage in figuring out the best ways to support each CEO’s unique goals.

    Comprehensive Data Access

    Before, everyone pretty much got the same generic introduction since the info was limited. But tools like SalesIntel and LeadIQ allow for way more customized contact now.

    By providing a huge pool of rich details on companies and their leaders, these platforms empower reps to personalize their whole strategy. Instead of a one-approach-fits-all, reps can craft unique discussions for each CEO based on deeper insights.

    It’s like the tools flipped the script completely. reps can aim connections directly at what really matters to specific executives now. 

    Detailed Professional Profiles

    Detailed Professional ProfilesDetailed Professional Profiles
    This Image Is Generated by Midjourney

    Being able to see a top boss’s past roles, accomplishments, and strengths really helps salespeople understand their path. It gives context for why they care about certain things.

    That knowledge is a goldmine for customizing connections. With insight into a CEO’s journey and long-term plans, reps can highlight how their product fits that vision perfectly.

    Instead of generic pitches, reps use profile details to craft conversations centered on what truly motivates each leader. Showing that type of understanding grabs way more attention than a one-size message.

    Areas of Expertise

    Knowing a CEO’s strengths lets reps customize their approach in very smart ways.

    For example, if a boss has experience in tech, reps can highlight how their product uses innovative solutions. Focusing on areas the CEO understands grabs their attention way more than a generic pitch.

    Being able to pinpoint backgrounds is such a gift. These sales intelligence programs provide details that help reps personalize outreach down to a very fine level.

    Matching messaging to a leader’s specific field of expertise makes the conversation immediately relevant to them. That sparks interest versus a one-size-fits-all message any CEO might ignore.

    Current Responsibilities

    CEO Sales ToolsCEO Sales Tools
    This Image Is Generated by Midjourney

    These sales tools give details on the projects and goals a leader is working on at that very moment. Reps can then craft messages showing how their product supports that specific work.

    Positioning offerings as direct aids for what’s front and center for the CEO now catches their eye way more than generic pitches. It shows the rep truly pays attention to what’s most pressing.

    Knowing current responsibilities is such a gift. It empowers reps to engage decision-makers with relevance to their immediate needs. And that type of personalized message is much more likely to lead to discussions about real partnerships.

    Technographic Insights

    Knowing what tech tools companies already use is important these days. These sales programs give details on things like which CRM or marketing programs different businesses have.

    That type of info lets reps spot where a company may be struggling with its current setup. Or maybe there’s room to add something new. Either way, reps can craft pitches highlighting exactly how their product improves or adds to the tech stack.

    Targeting needs or issues with existing systems is way smarter than generic messages. It shows the rep understands the company’s specific situation. And addressing real problems businesses have grabs way more attention than just saying what your product does.

    Behavioral Insights

    Sales ProgramsSales Programs
    This Image Is Generated by Midjourney

    Sales programs give details on what products bosses picked before and any challenges they mentioned. That type of info helps reps craft messages addressing real issues on a CEO’s mind.

    Knowing past decisions and future goals lets reps highlight exactly how their offering meets those aims. It shows they really pay attention to what motivates each leader long-term.

    Targeting past buying patterns and future visions is way smarter than one-size pitches. It proves to CEOs the rep understands their unique priorities. And addressing what drives key people grabs way more interest than generic sales speak.

    Being able to spot trends and aspirations from profiles truly empowers customized outreach. It gives reps the power to start important discussions focused on shared success. 

    Alternative Strategies for Contact Discovery

    Making friends in your field is super important for finding CEO info. Connecting with others leads to great referrals, helping you skip past locked-down details.

    Industry meetups are also goldmines. Face-to-face time lets you introduce yourself directly to bosses. Just be friendly and look for chances to chat.

    Don’t forget about company helpers too. Reaching out to assistants and such is smart. They know the executives and might pass your message along if they like you.

    Building networks and bonds takes effort, but it for sure pays off when trying to reach busy decision-makers. Personal relationships are key, so put yourself out there and represent your brand well at all events.

    Effective Communication with CEOs

    Effective Communication with CEOsEffective Communication with CEOs
    This Image Is Generated by Midjourney

    Emailing CEOs is tricky since you gotta make each one count. CEOs get tons of messages daily, so yours needs to stand out.

    Crafting the perfect note is like an art. Studies show emails to bosses do better than others, so focus there. Start with a catchy subject to grab their eye. Then make the opening line personal by name.

    Quickly tell them the “What’s in it for them” so they understand the benefits. Add any interesting info from your field too while pointing out advantages.

    Gently ask for a reply using soft calls to action, not pushy demands. And wrap it up neatly by signing off professionally yet friendly-like.

    The Bottom Line

    Sales is a tricky territory to cross, so keeping an open mind and trying different avenues is key. These tools and tactics together offer a full blueprint for tracking down busy decision-makers.

    The most important things are sticking with it, being willing to change plans, and always focusing on the value you bring. Reps have to show CEOs they truly care about supporting goals, not just making sales.

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    Natasa Pantelic

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  • Doctors Are Failing Patients With Disabilities

    Doctors Are Failing Patients With Disabilities

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    This piece was originally published by Undark Magazine.

    Ben Salentine, the associate director of health-sciences managed care at the University of Illinois Hospital and Health Sciences System, hasn’t been weighed in more than a decade. His doctors “just kind of guess” his weight, he says, because they don’t have a wheelchair-accessible scale.

    He’s far from alone. Many people with disabilities describe challenges in finding physicians prepared to care for them. “You would assume that medical spaces would be the most accessible places there are, and they’re not,” says Angel Miles, a rehabilitation-program specialist at the Administration for Community Living, part of the Department of Health and Human Services.

    Not only do many clinics lack the necessary equipment—such as scales that can accommodate people who use wheelchairs—but at least some physicians actively avoid patients with disabilities, using excuses like “I’m not taking new patients” or “You need a specialist,” according to a paper in the October 2022 issue of Health Affairs.

    The work, which analyzed focus-group discussions with 22 physicians, adds context to a larger study published in February 2021 (also in Health Affairs) that showed that only 56 percent of doctors “strongly” welcome patients with disabilities into their practice. Less than half were “very confident” that they could provide the same quality of care to people with disabilities as they could to other patients. The studies add to a larger body of research suggesting that patients with conditions that doctors may deem difficult to treat often struggle to find quality care. The Americans With Disabilities Act of 1990 (ADA) theoretically protects the one in four adults in the U.S. with a disability from discrimination in public and private medical practices—but enforcing it is a challenge.

    Laura VanPuymbrouck, an assistant professor in the Department of Occupational Therapy at Rush University, calls the 2021 survey “groundbreaking—it was the crack that broke the dam a little bit.” Now researchers are hoping that medical schools, payers, and the Joint Commission (a group that accredits hospitals) will push health-care providers for more equitable care.


    Due in part to scant data, information about health care for people with disabilities is limited, according to Tara Lagu, a co-author of both the 2021 and 2022 papers and the director of the Institute for Public Health and Medicine’s Center for Health Services & Outcomes Research at Northwestern University Feinberg School of Medicine. The few studies that have been done suggest that people with disabilities get preventive care less frequently and have worse outcomes than their nondisabled counterparts.

    About a decade ago, Lagu was discharging a patient who was partially paralyzed and used a wheelchair. The patient’s discharge notes repeatedly recommended an appointment with a specialist, but it hadn’t happened. Lagu asked why. Eventually, the patient’s adult daughter told Lagu that she hadn’t been able to find a specialist who would see a patient in a wheelchair. Incredulous, Lagu started making calls. “I could not find that kind of doctor within 100 miles of her house who would see her,” she says, “unless she came in an ambulance and was transferred to an exam table by EMS—which would have cost her family more than $1,000 out of pocket.”

    In recent years, studies have shown that even when patients with disabilities can see physicians, their doctors’ biases toward conditions such as obesity, intellectual disabilities, and substance-use disorders can have profound impacts on the care they receive. Physicians may assume that an individual’s symptoms are caused by obesity and tell them to lose weight before considering tests.

    For one patient, this meant a seriously delayed diagnosis of lung cancer. Patients with mobility or intellectual challenges are often assumed to be celibate, so their providers skip any discussion of sexual health. Those in wheelchairs may not get weighed even if they’re pregnant—a time when tracking one’s weight is especially important, because gaining too little or too much is associated with the baby being at risk for developmental delays or the mother being at risk for complications during delivery.

    These issues are well known to Lisa Iezzoni, a health-policy researcher at Massachusetts General Hospital and a professor of medicine at Harvard Medical School. Over the past 25 years, Iezzoni has interviewed about 300 people with disabilities for her research into their health-care experiences and outcomes, and she realized that “every single person with a disability tells me their doctors don’t respect them, has erroneous assumptions about them, or is clueless about how to provide care.” In 2016, she decided it was time to talk to doctors. Once the National Institutes of Health funded the work, she and Lagu recruited the 714 physicians that took the survey for the study published in 2021 in Health Affairs.

    Not only did many doctors report feeling incapable of properly caring for people with disabilities, but a large majority held the false belief that those patients have a worse quality of life, which could prompt them to offer fewer treatment options.

    During the 2021 study, Iezzoni’s team recorded three focus-group discussions with 22 anonymous physicians. Although the open-ended discussions weren’t included in the initial publication, Lagu says she was “completely shocked” by some of the comments. Some doctors in the focus groups welcomed the idea of additional education to help them better care for patients with disabilities, but others said that they were overburdened and that the 15 minutes typically allotted for office visits aren’t enough to provide these patients with proper care. Still others “started to describe that they felt these patients were a burden and that they would discharge patients with disability from their practice,” Lagu says. “We had to write it up.”

    The American Medical Association, the largest professional organization representing doctors, declined an interview request and would not comment on the most recent Health Affairs study. When asked about the organization’s policies on caring for patients with disabilities, a representative pointed to the AMA’s strategic plan, which includes a commitment to equity.


    Patients with disabilities are supposed to be protected by law. Nearly 50 years ago, Congress passed Section 504 of the Rehabilitation Act of 1973, which prohibited any programs that receive federal funding, such as Medicare and Medicaid, from excluding or discriminating against individuals with disabilities. In 1990, the ADA mandated that public and private institutions also provide these protections.

    The ADA offers some guidelines for accessible buildings, including requiring ramps, but it does not specify details about medical equipment, such as adjustable exam tables and wheelchair-accessible scales. Although these items are necessary to provide adequate care for many people with disabilities, many facilities lack them: In a recent California survey, for instance, only 19.1 percent of doctor’s offices had adjustable exam tables, and only 10.9 percent had wheelchair-accessible scales.

    Miles says she’s noticed an improvement in care since the ADA went into effect, but she still frequently experiences challenges in health care as a Black woman who uses a wheelchair. “We need to keep in mind the ADA is not a building code. It’s a civil-rights law,” says Heidi Johnson-Wright, an ADA coordinator for Miami-Dade County in Florida, who was not speaking on behalf of the county. “If I don’t have access to a wellness check at a doctor’s office or treatment at a hospital, then you’re basically denying me my civil rights.”

    The ADA isn’t easy to enforce. There are no “ADA police,” Johnson-Wright says, to check if doctor’s offices and hospitals are accessible. In many cases, a private citizen or the Department of Justice has to sue a business or an institution believed to be in violation of the ADA. Lawyers have filed more than 10,000 ADA Title III lawsuits each year since 2018. Some people, sympathizing with businesses and doctors, accuse the plaintiffs of profiteering.

    And it’s not just about accessible equipment. In 2018, the Justice Department sued a skilled nursing facility for violating the ADA, after the facility refused to treat a patient with a substance-use disorder who needed medication to help maintain sobriety. Since then, the department settled with eight other skilled nursing facilities for similar discrimination. “It is a violation of the ADA” to deny someone care based on the medications they need, Sarah Wakeman, an addiction-medicine specialist at Massachusetts General Hospital, wrote in an email, “and yet continues to happen.”

    Indeed, in the focus groups led by Lagu and Iezzoni, some of the doctors revealed that they view the ADA and the people it protects with contempt. One called people with disabilities “an entitled population.” Another said that the ADA works “against physicians.”

    The Department of Health and Human Services is aware of the issue. In a response to emailed questions, an HHS spokesperson wrote, “While we recognize the progress of the ADA, important work remains to uphold the rights of people with disabilities.” The Office of Civil Rights, the spokesperson continued, “has taken a number of important actions to ensure that health care providers do not deny health care to individuals on the basis of disability and to guarantee that people with disabilities have full access to reasonable accommodations when receiving health care and human services, free of discriminatory barriers and bias.”


    Researchers and advocates told me that the key to improving health care for those with disabilities is addressing it directly in medical education and training. “People with disabilities are probably one of the larger populations” that physicians serve, Salentine said.

    Ryan McGraw, a community organizer with Access Living, helps provide education about treating patients with disabilities to medical schools in the Chicago area. He regularly receives positive feedback from medical students but says the information needs to be embedded in the medical-school curriculum, so it’s not “one and done.”

    In one effort to address the issue, the Alliance for Disabilities in Health Care Education, a coalition of professionals and educators of which McGraw is a member, put together a list of 10 core competencies that should be included in a doctor’s education, including considerations for accessibility, effective communication, and patient-centered decision making.

    One of the simplest solutions might be hanging signs or providing accessible information in exam rooms on patients’ rights. “It’d be there for patients, but it’d be also there as a reminder to the providers. I think that’s a super easy thing to do,” Laura VanPuymbrouck says. Miles says this could be a good start, but “it’s not enough to just give people a little pamphlet that tells you about your rights as a patient.” Although all doctors should be willing and able to care for patients with disabilities, she thinks a registry that shows which providers take certain types of insurance, such as Medicaid, and also have disability accommodations, such as wheelchair-accessible equipment, would go a long way.

    Some advocates have called on the Joint Commission for more than 10 years to require disability accommodations for hospitals that want accreditation. The step could be effective, because accreditation “is extremely important” to hospitals, Lagu says.

    On January 1, 2023, new Joint Commission guidelines will require that hospitals create plans to identify and reduce at least one health-care disparity among their patients. Improving outcomes for people with disabilities could be one such goal. However, Maureen Lyons, a spokesperson for the Joint Commission, adds, “if individuals circumvent the law, standards won’t be any more effective.”

    Finally, Lagu says, “we have to pay more when you are providing accommodations that take time or cost money. There’s got to be some accounting for that in the way we pay physicians.”

    One of the most basic things people with disabilities are asking for is respect. The biggest finding of the 2021 survey, Iezzoni says, is that doctors don’t realize that the proper way to determine what accommodations a facility needs for patients with disabilities is to just ask the patients.

    “I can’t tell you how many times I go to a doctor’s office and I’m talking, but they’re not hearing anything,” Salentine says. “They’re ready to speak over me.”

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    Emma Yasinski

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