Importance Despite documented disparities in health care for patients with significant vision impairments and legal mandates that patients with disability receive equitable care, little is known about the extent to which physicians practicing in the US accommodate these patients in outpatient clinical settings.

Objective To empirically explore the extent of basic accommodations physicians practicing in the US provide to patients with significant vision limitations in outpatient care.

Design, Setting, and Participants In this physician survey study, randomly selected physicians were surveyed throughout the US on their attitudes toward patients with disability. A total of 1400 randomly selected active board-certified physicians representing 7 specialties (family medicine, general internal medicine, rheumatology, neurology, ophthalmology, orthopedic surgery, and obstetrics-gynecology) were surveyed. Data were collected from October 2019 to June 2020.

Main Outcomes and Measures Reported use of basic accommodations when caring for patients with significant vision limitations (defined here as blind or significant difficulty seeing even with glasses or other corrective lenses). Physicians’ accommodation performance was assessed based on whether they always or usually described the clinic space and always or usually provided printed material in large font. Use of Braille materials was reported too rarely to include in analyses.

Results Of the 462 survey participants, 297 of 457 (65.0%) were male. The weighted response rate was 61.0%. Only 48 physicians (9.1%; 95% CI, 6.6-12.3) provided both accommodations (always or usually describing clinic spaces and providing large-font materials), while 267 (60.2%; 95% CI, 55.3-65.0) provided neither of these accommodations. Although 62.8% (95% CI, 57.5-67.8; n = 245) of nonophthalmologists did not provide either accommodation, 29.3% (95% CI, 20.1-40.7; n = 22) of ophthalmologists also did not do so; only 24.0% (95% CI, 15.6-35.0; n = 18) of ophthalmologists provided both accommodations compared with 8.4% (95% CI, 5.4-12.7) of other physicians.

Conclusions and Relevance This survey study suggests that less than one-tenth of physicians practicing in the US who care for patients with significant vision limitations usually or always describe clinic spaces or provide large-font materials, and less than one-third of ophthalmologists do so. Actions to address this seem warranted.

重要性 尽管有记录表明在严重视力障碍患者的医疗保健方面存在差异，并且法律要求残疾患者接受公平的护理，但对于在美国执业的医生在门诊临床环境中为这些患者提供的程度知之甚少。

目的 实证探讨在美国执业的医生在门诊治疗中为视力严重受限的患者提供的基本便利程度。

设计、背景和参与者 在这项医生调查研究中，随机选择了美国各地的医生，调查他们对残疾患者的态度。对代表 7 个专业（家庭医学、普通内科、风湿病学、神经病学、眼科、整形外科和妇产科）的 1400 名在职委员会认证医师进行了调查。数据收集时间为 2019 年 10 月至 2020 年 6 月。

主要结果和措施 报告在照顾有严重视力限制的患者（此处定义为失明或即使戴眼镜或其他矫正镜片也有明显困难）时使用基本调节。医生的便利表现根据他们是否总是或经常描述诊所空间以及总是或经常提供大字体印刷材料来评估。盲文材料的使用很少被报告包括在分析中。

结果 在 462 名调查参与者中，457 人中有 297 人 (65.0%) 为男性。加权响应率为 61.0%。只有 48 名医生 (9.1%; 95% CI, 6.6-12.3) 提供这两种便利（总是或通常描述诊所空间并提供大字体材料），而 267 名 (60.2%; 95% CI, 55.3-65.0) 两者都不提供这些住宿。尽管 62.8% (95% CI, 57.5-67.8; n = 245) 的非眼科医生没有提供任何住宿，但 29.3% (95% CI, 20.1-40.7; n = 22) 的眼科医生也没有这样做；只有 24.0%（95% CI，15.6-35.0；n = 18）的眼科医生提供这两种便利，而其他医生的这一比例为 8.4%（95% CI，5.4-12.7）。

结论和相关性 这项调查研究表明，只有不到十分之一的美国执业医师会照料视力严重受限的患者，通常或总是描述诊所空间或提供大字体材料，而只有不到三分之一的眼科医生这样做. 解决这个问题的行动似乎是必要的。