Wheelchair users and others who have trouble standing and walking have a tough time climbing onto traditional-height exam tables and balancing on stand-up weight scales. By cutting corners on exams and estimating weight and height, the healthcare provider might miss warning signs for serious ailments. Physicians who are unable to examine a patient in a supine or prone position on an exam table or weigh and measure a patient during an office visit may misdiagnose or prescribe incorrect dosages based on insufficient information.
Additionally, the healthcare provider might omit or not recommend procedures which would otherwise be performed for an able-bodied patient, opening the provider to malpractice exposure and/or accusations of discrimination.
Lastly, patients who have difficulty climbing onto an exam table and scale may find being examined so demeaning, exhausting and futile that they stop visiting their healthcare provider altogether, thereby reducing or eliminating preventive care.
The Importance of Examining a Patient in the Supine Position
For patients with mobility challenges, the exam is often limited to what can take place while the patient is seated in a wheelchair. When this happens, the physical exam is less than comprehensive. The result is an incomplete exam and a frustrated patient.
According to Bates’ Guide to Physical Examination and History Taking (10th Edition), a comprehensive adult physical examination will include an evaluation of the following systems with the patient in supine position:
- Anterior thorax and lungs
- Cardiovascular system
- Lower extremities
- Rectal and genital examination
The UpScale allows for a head-to-toe examination for all patients, regardless of mobility. The UpScale’s accessible patient stirrups also facilitate pelvic exams for patients with mobility challenges.
The Importance of Patient Weight and Height Measurement
A patient’s weight is a critical data point for a variety of medical reasons, including diagnosing and tracking obesity, cancer, high blood pressure, cardiovascular disease, diabetes and depression. It’s particularly important that weight be measured throughout a woman’s pregnancy – both for her health and for that of her baby.
Best medical practices suggest that a baseline weight measurement be taken as part of any new-patient exam. The baseline is used to compare to measurements taken at future visits. Weight, taken together with height, is used to calculate the patient’s body mass index (BMI), a crucial factor in determining a patient’s overall health and correctly dosing both medication and anesthesia.
Recognizing the need to track weight and height as a preventive measure, Medicare’s Initial Preventive Physical Examination (IPPE) requires medical practitioners to measure the patient’s weight and height. These measurements must be repeated during annual “wellness” visits.
Both the US Preventive Service Task Force (Guide for Clinical Preventive Services) and the Commission on Public Health and Scientific Affairs (American Academy of Family Physicians) recommend taking height and weight measurements for patients age 19-64 and calculating BMI periodically as a preventive intervention.
Oftentimes, patients unable to stand and balance on traditional stand-up weight scales are asked to estimate their weight or asked what their weight was the last time they were weighed, which may have been many years before. Physicians are then put in the uncomfortable position of guessing a patient’s weight, estimating an appropriate medication dosage, and/or missing a diagnosis altogether. Wheelchair users are acutely aware that they are not receiving equal care as able-bodied patients when they are asked to “guess-timate” both their height and weight.
The UpScale meets the needs of practitioners who aim to provide the best, most comprehensive care for all patients, regardless of their mobility.