Health care of the deaf--toward a new understanding.

I have been asked to contribute this guest editorial to provide further perspective on the health care experience of elderly deaf patients reported in the article by Witte and Kuzel in this issue. l Accordingly, this editorial explores the availability and problems of medical care for the elderly Deaf in Richmond, Va, area as well as comments on health care delivery to the Deaf population at large. As in the accompanying article, I, too, will use the word deaf to represent people with severe hearing impairment and Deaf to represent the subset that feels linked culturally. From my experiences as a graduate of a school for the Deaf (The New York School for the Deaf, popularly known as PS 47), as the first graduate of a Deaf school to earn his medical degree, and as the former physician for the California School for the Deaf and the California School for the Blind (Fremont, Calif), my comments might be quite upsetting and controversial to many Deaf and professionals in the field of the (d)Deaf. As I see it and as the authors point out, the root of the problem of health care delivery to the Deaf is communication. I am not speaking of communication in the limited sense of physician and patient conversing, but in the broader context, such as, calling the physician's office, the physician's office calling the patient, or a deaf patient calling the laboratory, pharmacy, hospital, or specialist. Here the greater onus is on the Deaf person, who faces the challenge of good communication all his or her life. Medical professionals, on the other hand, have very limited exposure to and knowledge of the Deaf. Every (d)Deaf patient should inform his or