Meeting the needs of the developmentally disabled: How doctors offer treatment

Physicians and advocates for adults with mental retardation and developmental disabilities are working to ensure that these patients do not fall through the cracks.

By Victoria Stagg Elliott, AMNews staff. Aug. 2, 2004.

Chris Prater, MD, a family physician in Chattanooga, Tenn., gets part of his pay in hugs. As the medical director of the Orange Grove Center, an agency serving patients with mental retardation and developmental disabilities, he provides thousands with much-needed primary care services.

"I've been here two hours today, and I've already gotten probably 20 hugs and kisses," he said one morning. "I can't stand it. They love me. I love them."

Many of his patients can't communicate very well. Some might have significant co-morbidities related to their disabilities. And sometimes they must be driven to the door several times before they'll come into the office. It could take several more visits after that before they'll let him actually examine them.

"We gradually work them into the lobby of our place, and then into the waiting room and then into the office," Dr. Prater said. "And once we get them in, for a lot of them, this is their favorite place to go, because we baby them so much."

Dr. Prater is part of a growing cadre of physicians attempting to deliver high-quality primary care in a specialized clinic setting because of a recognition that the needs of adults with mental retardation and developmental disabilities is so great and, for the most part, unmet.

"This patient population has not had equal access," said Steven D. Lowe, MD, an internist at Premier HealthCare, a New York City center providing primary health care services to this population. "I know this because I've seen countless patients who have fallen through the cracks with such severe medical problems you can't believe that they haven't come to the attention of the medical community."