To explore how people with mobility disabilities navigate healthcare spaces and identify barriers and patient-derived solutions.

People with disabilities face barriers to healthcare at policy, neighborhood, and provider levels. A less-studied factor is the accessibility of healthcare environments-the physical and operational structures of clinical spaces-and how these shape patient experiences. This study addresses this gap by capturing real-time experiences of patients with mobility disabilities.

We conducted qualitative Go-Along (“walking”) interviews, a participatory method capturing how built environments affect individuals. Eighteen participants from an academic neurology clinic completed pre-appointment interviews, direct observation during outpatient appointments (lobby/parking, elevators, walkways, waiting area, check-in/out, exam rooms), and post-appointment interviews. Thematic analysis followed the political-relational model of disability.

Four themes emerged.

(1) Healthcare environments were often inaccessible, and retrofitting inconsistent. Barriers included lack of accommodation processes, inaccessible parking, inadequate waiting-room space for assistive devices, inaccessible medical equipment, and distant clinic rooms.

(2) Patients shouldered the burden of inaccessibility, developing workarounds or relying on friends/family, often with significant cognitive and physical burden. Some delayed or canceled care:

“I've canceled appointments, because I'm too fatigued to put the energy needed for the whole experience.”

“Lot of times, it's easier to stay home..if you looked at my record of cancelling and rescheduling, you think my heavens, this girl is not consistent or can't be counted upon..It takes a lot. It really does..”

(3) Participants provided concrete recommendations, e.g. structured assistance programs and better way-finding.

(4) Positive clinician/staff interactions contrasted with persistent system-level barriers.

Healthcare environments and processes are often not designed with patients with mobility disabilities in mind. Accessibility is more than meeting minimum legal mandates (e.g. ADA). Inaccessible systems burden patients, contributing to missed or delayed care. Co-designing healthcare spaces with disabled individuals can improve access, benefiting both patients and health systems, especially with an aging population.