Accessibility for medical websites: what the ADA expects and what patients need

A medical website serves a population that includes people with low vision, hearing loss, tremor, color blindness, cognitive fatigue and old phones. Many of them are the patients who need the practice most. Accessibility is the set of decisions that lets all of them read the hours, find the phone number and request an appointment without help.

It is also an area of legal exposure that has grown quietly. This article explains, in plain language, what the ADA is being used to claim about websites, what the WCAG 2.1 AA standard actually asks for, what a practice can check by itself and what to ask the team that builds or maintains the site. It is general information, not legal advice; a lawyer decides what applies to your practice.

What the ADA has to do with a website

Title III of the Americans with Disabilities Act requires places of public accommodation to be accessible to people with disabilities. A physician’s office is explicitly one of those places. The law was written before the web existed, and it does not mention websites. For years, the open question was whether a website counts as part of the public accommodation.

In practice, the question has been answered mostly through lawsuits and demand letters rather than a single regulation. Plaintiffs, often represented by firms that file many similar cases, argue that a site a blind patient cannot use denies access to the practice. Federal courts have reached different conclusions in different circuits, the Department of Justice has repeatedly stated that it considers the ADA to apply to websites of businesses open to the public, and in 2024 it published a formal rule for state and local government sites that adopts WCAG 2.1 AA as the technical standard. Private practices are not covered by that rule, but it signals which standard everyone points to.

What this means for a practice: there is no checklist that guarantees immunity, but there is a widely recognized standard, and a site that meets it is far harder to claim against and far easier for patients to use. Whether a specific site needs a specific fix is a question for your attorney.

WCAG 2.1 AA in plain language

The Web Content Accessibility Guidelines are published by the W3C, the organization that maintains web standards. Version 2.1 is the one most often cited; level AA is the middle of three levels and the one regulators and courts reference. The guidelines are organized around four ideas: content must be perceivable, operable, understandable and robust. For a practice site, that translates into a manageable list.

Contrast

WCAG asks for a contrast ratio of at least 4.5 to 1 between normal text and its background, and 3 to 1 for large text. Light gray on white, the most common look in modern templates, usually fails. So do white letters over a photo of the office. Free contrast checkers accept two colors and return the ratio in a second.

Forms

Appointment request and contact forms are where accessibility failures do the most damage, because they are the point of the site. Each field needs a label that a screen reader announces, not just placeholder text that vanishes when someone starts typing. Errors must be described in words (“please enter a phone number”), not signaled only by a red border. The submit button must be reachable and pressable with the Tab and Enter keys. If your form collects health details, the privacy considerations for a medical contact form apply on top.

Alt text

Every image that communicates something needs an alternative text description: “Dr. Martinez in the exam room” or “Front entrance of the clinic on Kennedy Boulevard”. Decorative images should be marked so screen readers skip them. Photos of text, such as a scanned insurance list or a flyer, are a specific problem: the information in them is invisible to a screen reader and must exist as real text somewhere on the page.

Captions and transcripts

A welcome video from the physician, a walkthrough of a procedure, a recorded explanation of what to expect: all need captions, and captions generated automatically need to be reviewed, because medical terms are exactly the words automatic captioning gets wrong. Audio-only content needs a transcript.

Keyboard and screen reader navigation

Some patients cannot use a mouse. Everything on the site, including menus, dropdowns, pop-ups and the appointment form, must work with the keyboard, and the element currently selected must be visibly highlighted. Headings should follow their order (one main heading, then sections, then subsections) so that someone using a screen reader can jump between them the way a sighted reader scans.

What a practice can check by itself

You do not need an expert to find the most common problems. An afternoon with these checks reveals most of what a demand letter would cite.

• Unplug the mouse. Use Tab, Shift+Tab, Enter and the arrow keys to reach the phone number, open the menu and submit the appointment form. Note anywhere you get stuck or lose sight of where you are.
• Turn on the screen reader built into your phone (VoiceOver on iPhone, TalkBack on Android) and listen to the homepage. Images announced as “image” or by their file name have no description.
• Zoom the browser to 200 percent. Text should reflow; nothing should be cut off or overlap.
• Run a free automated checker such as WAVE or the Lighthouse accessibility audit built into Chrome. They catch roughly a third of the issues, which is enough to start.
• Play any video with the sound off. If you cannot follow it, neither can a patient with hearing loss.
• Look at every form. Does each field have a label that stays visible? What happens when you submit it empty?

Write down what you find. Even if a vendor does the fixes, the list tells you whether the work was done and gives you something concrete to hand to counsel if a letter ever arrives.

What to ask the team that builds or maintains the site

Overlay tools deserve a specific warning. They promise to make any site accessible by adding a script, and they are marketed heavily to medical practices. Disability advocates and many accessibility professionals have documented that they frequently interfere with the assistive technology patients already use, and sites running them have still been named in claims. They are not a substitute for building the site correctly.

Why this helps beyond the legal question

Every one of these fixes also helps patients with no disability at all: the person reading the site in bright sunlight, the one filling out the form on a cracked phone, the one watching the video in a waiting room with the sound off. Search engines read the same signals, which is why alt text, headings and readable structure show up in every SEO checklist too.

Accessibility is part of how we build every medical web platform, and a website audit includes an accessibility review of the site you already have, in a written report you can act on or hand to your attorney. Questions before that? Contact us and we reply within one business day.

Article written by

Roger de Oca

Web designer, developer, and founder of DEOCAs. Roger builds and maintains web platforms for physicians and medical organizations, including the 2025-2026 president of a national medical society, and writes about what actually works for practices online.

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This article is general information for physicians and practice managers, not legal, medical or financial advice. Rules and prices change; confirm anything that affects your practice with your own advisors.