Gynecological care for adolescents with disability: physician comfort, perceived barriers, and potential solutions.

OBJECTIVE: The goal of this study was to assess the barriers to gynecologic care for adolescents with disability in this state.

DESIGN: Providers of gynecologic care in Utah were surveyed to assess existing conditions, attitudes, and comfort levels regarding this population.

RESULTS: The survey was completed by 136 gynecologic clinicians (50% return rate). The comfort level among surveyed clinicians in providing gynecological care to disabled adolescents was relatively low, even for routine screening. Respondents identified the following as barriers to providing this care: time, reimbursement, inadequate knowledge, and disability-related issues (office access and preference to not serve this population). Suggested solutions included: continuing education programs, consultation to practices on serving both youth and individuals with disability, and better billing mechanisms.

CONCLUSION: While many of the surveyed clinicians are comfortable providing care to adolescents with disability, a substantial number are not. Respondents perceive many barriers to providing care to this population, though the barriers appear modifiable. Potential interventions were identified which should be tested for their effectiveness in improving access to quality care for this underserved population.