Federal law requires physicians to accommodate hearing-impaired patients.

63 The federal Americans with Disabilities Act (ADA) of 1990 prohibits discrimination based on disability in a number of settings, including private establishments that cater to the public, which includes physician offices and hospitals. As a result, physicians cannot refuse to provide treatment to a disabled person because of disability, and they must provide, free of charge, any auxiliary aids and services that are necessary to communicate effectively with patients who have disabilities that affect vision, speech or—most commonly—hearing. The federal regulations that implement the ADA define “auxiliary aids and services” related to the hearing impaired to include qualified interpreters, note taking, written materials, and telecommunications devices for deaf persons or other effective methods of making aurally delivered materials available to individuals with hearing impairments.1 Physicians must determine, in consultation with the patient, the appropriateness of providing an interpreter or other auxiliary aid or service to a hearing impaired patient. The ADA does not require that an interpreter be provided during every contact with a hearingimpaired patient, but rather requires that communication between the physician and the patient be as effective as communication with patients who are not hearing impaired. In some instances, passing notes to the patient may satisfy the requirements of the ADA, while in