Success is Accessible!

When choosing or upgrading your office there is one consideration that will have a profound impact. Prioritizing it will help you —

  • retain clients for decades
  • appeal to clients who need your services regularly
  • decrease the need to make house calls
  • contract with insurance companies
  • participate in federal programs (such as Veterans Choice and ACA plans)
  • gain respect and referrals from other health care providers
  • keep your office in one location for the duration of your career
  • reduce legal threats
  • minimize workplace injuries to you and your staff
  • comply with civil rights law.

It’s a win, win, win, win, win, win, win,win, win, win.

That consideration is compliance with the Americans with Disabilities Act of 1990 (ADA), a federal civil rights law that prohibits discrimination against individuals with disabilities in every day activities, including medical services. Any private entity that owns, leases or leases to, or operates a place of public accommodation (that includes your office) is responsible for complying with Title III of the ADA. (Source – DOJ/HHS Publication)

19% of the US population reported having a disability in the 2010 census.

If you are blessed with good client retention and a lengthy career your patient population is likely to increasingly include those with disabilities. You might develop your own temporary, or permanent, mobility issues.

Acupuncture schools need to teach students about our responsibilities under the ADA. Ethics classes should address the de facto discrimination that occurs when we choose inaccessible work spaces. And, when practitioners seek advice from peers about potential office arrangements, renovations, or accommodations (such as interpreters) emphasis should be on the legal, ethical, and practical benefits of compliance. Preemptive absolution is offered too often, especially by those who don’t understand the law.

The ADA does include exemptions to protect small businesses from accommodations that would be an “undue burden.” Is a $2,000 lift table an undue burden? How much have you spent on Biomats, lasers, tuning forks, and travel to conferences? Rent for a first floor office might be more, but house calls also affect your bottom line. (If you rely on house calls to comply with the ADA requirements for accessibility, remember: you can’t charge more, you must offer the same level of service, you have to offer flexible scheduling as you would to your in-office clients, and, if you are accepting new clients it is discrimination not to accept those whose disability would make your office inaccessible.)

It’s true, individual practitioners who don’t comply are unlikely to suffer legal consequences and many Practices flourish despite a lack of accessibility.

“Getting away” with not complying is no way to run a business or a health care profession. Doing all we can to meet the needs of those with disabilities is good business, good for the profession, and good for the public. It should be a top priority.

Here are some resources to help you understand the ADA and our responsibilities —

Access to Medical Care for Individuals with Mobility Disabilities

Americans with Disabilities Act Title III Regulations

Title III Highlights

ADA Q & A for Health Care Providers

ADA Checklist for Existing Facilities

ADA and Small Businesses

NPR Story about Accessing Care for People with Disabilities

Post on California Law impacting Lease negotiations

ADA Enforcement Activities

ADA in a Health Care Context

ADA for Deaf and Hard of Hearing


Copyright —

© Elaine Wolf Komarow and The Acupuncture Observer, 2013-2033. Unauthorized use and/or duplication of this material without express written permission from Elaine Wolf Komarow is prohibited. Excerpts and links are encouraged, provided that full and clear credit is given with specific direction to the original content.

10 thoughts on “Success is Accessible!

  1. Good post. I agree that we can be better prepared if we have had a phone conversation w patient beforehand.
    If table needs to be lowered/raised for a patient, we can do that by hand.

    • True, but a table low enough for a client to get on may be a table so low that it’s difficult for you to work comfortably. A lift table allows you to adjust it once the client is one it, so that is a plus.

  2. it is affirming to read your words here, in my 18 years as an acupuncturist, I have always refused offices that cannot be accessed by the handicapped or disabled.
    I will not do house calls b/c of this accessibility. However, I do not use tuning forks or lasers and I will not be buying any treatment table you describe here. I have found if I ask ahead of their visit, the disabled/handicapped person will be able to tell me what they foresee they need to receive acupuncture. I believe initial communication is key so that a practioner is well prepared to meet each INDIVIDUAL so that acupuncture treatment is accessible. I think that point was unaddressed in your article. Initial assessment of individual need. If one is willing to make a house call, certainly that same amount of time can be used to speak on the telephone before the first visit into the office to set everything in place, IF IT IS NOT ALREADY. Including, bringing an attendant to assist with transports fromwheel chairs/walkers to treatment spaces and to assist if there is more special needs than ANY ONE ACUPUNCTURIST is equipped to handle, even though they are set up to receive and treat the disabled to begin with.

    • Thanks for your input.

      I brought up house calls because often, when someone asks about an office up a flight of stairs, people answer “that’s fine as long as you will do house calls.” I brought up tuning forks and lasers because practitioners often spend significant sums on that sort of “add-on” while claiming that spending money on accommodations for the disabled is an undue burden.

  3. Above and beyond the ADA expenditures, my question is: How many acupuncture clinics have an automated external defibrillator (AED)? In my experience, almost none, and that is more important than fancy acupuncture tools, travel to conferences or even ADA compliance. They cost about $1000, and a few hundred more every few years for expired pads. So if you intend to spend money to retrofit your space, an AED should be the number one item on the list. If you have more than one person working your clinic, you should also have a mask-bag assembly for team-administered CPR. An AED is the only device I can think of that can save someone’s life. Your clinic should be the safest place in the neighborhood to have a heart attack.

    • Thanks for bringing that up, John. For those in more typical office buildings, you can at least make sure you know if there are AED’s around, and if so, where they are.

      Two additional thoughts — the current teaching on CPR stresses the compression over respiration part of the equation. I’m not arguing that the mask-bag isn’t worth happening, but not having one shouldn’t keep a practitioner from doing chest compressions.

      The other thought — I don’t want to quibble about what is most important, but, well — we have a legal requirement for ADA compliance, not so for and AED. And, ADA compliance is something that can benefit public health on a daily basis. My office access is a factor on a weekly basis. An AED can absolutely be lifesaving, but, thank goodness, I haven’t needed to use one in the past 21 years.

      So, in short. Yes, get an AED. It’s worth it. And pay attention to ADA too.

  4. Nice to hear we are covered under Veterans Choice Program, even though it’s a federal program, which typically doesn’t cover acupuncture.
    As reimbursement, they follow Medicare fee schedule.
    Do you know what that is?
    Or how to go and find out?
    Because Medicare doesn’t acupuncture, hence no CPT codes.

    • I have heard of practitioners participating in Veteran’s Choice, but I honestly have no idea how it works, how much it pays, etc. Most of the posts I’ve seen are from people saying they’ve submitted claims but have yet to receive any reimbursement, so I suppose that isn’t a good sign. You may be able to learn more through Facebook or your state associations. However, even if there isn’t much room for participation at the moment, this could change. That’s one of the reasons to keep accessibility in mind when you start out or select new space. You never know when new opportunities will present themselves.

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