Field Notes · 03

10 telltale signs your medical website is not accessible

You do not need an audit tool to spot most accessibility failures on a clinic website. Here are the ten I find on nearly every first visit, and what each one costs you.

Patrick Jean-Baptiste · August 22, 2026

Most clinic owners assume their website is accessible because nobody has complained. That is the wrong signal to watch. A patient who cannot read your hours or book an appointment does not file a complaint. They call another practice, or they do nothing, and you never hear about it.

I review a lot of medical websites. Most were built by well-meaning people on templates that nobody tested with a keyboard or a screen reader. The same problems show up again and again.

You can find every one of them yourself in under thirty minutes. You need no scanner, no plugin and no consultant. Here are the ten I check first.

1. You cannot get through the site with the Tab key

Put your mouse away. Load your home page and press Tab, then keep pressing it. Every link, button, menu item and form field should light up in order. You should always be able to see which element is selected.

Watch for three failures. The focus outline vanishes. You get stuck inside the navigation menu. The "Book Now" button never receives focus, because it is a styled div and not a real button. Any of these fails the most basic test there is.

Keyboard navigation is how screen reader users move through a page. People with tremors, repetitive strain injuries and many motor disabilities browse the same way. It is also the first thing a plaintiff's firm checks.

2. Images have no alt text, or the alt text is the file name

Right-click any image on your site and inspect it. Look at the alt attribute. It may be missing. It may be empty on an image that carries meaning. It may read IMG_4471.jpg or doctor-smiling-stock-photo. In each case a blind patient hears nothing useful, and a search engine indexes nothing useful.

This one counts twice. Alt text is an accessibility requirement, and it is one of the few on-page SEO levers that still works. Take a photo of your front entrance with alt text that describes the entrance, the ramp and the parking. It helps a wheelchair user decide whether to visit, and it helps Google understand the page. Alt text stuffed with "best pediatrician West Palm Beach" helps nobody and can hurt you.

3. Light gray text on white

Designers love it. Most people over fifty cannot read it. WCAG 2.1 requires a contrast ratio of at least 4.5 to 1 for body text and 3 to 1 for large text. The soft gray that ships with most themes lands around 2.5 to 1.

Medical practices are exposed here. Many of your patients, or the parents and caregivers of your patients, have reduced vision. Others are reading on a phone in a parking lot, or hunting for your after-hours number at two in the morning. Contrast is the cheapest fix on this list, and it pays off for the most people.

4. Your forms do not have real labels

Placeholder text inside a field is not a label. It disappears the moment someone starts typing, and a screen reader may never announce it at all.

Look at your appointment request form, your new patient intake form and your contact form. Each field needs a visible <label> element tied to it with a for attribute. Required fields need to say so in words. A lone red asterisk is not enough.

Forms are where accessibility failures turn into lost revenue. A form a patient cannot finish is an appointment you never got.

5. Error messages that only change color

Submit one of your forms with a field left blank. Maybe the only thing that happens is the field border turns red. A colorblind user sees nothing. A screen reader user hears nothing. Both are stuck.

Errors need to be written out in text, placed next to the field and announced to assistive technology.

6. The site depends on hover

Some menus open only on mouse hover. Some tooltips explain a service only when the cursor rests on an icon. Some image captions appear only on rollover. None of that exists for someone on a touch screen or a keyboard.

If important information appears on hover and nowhere else, a large share of your patients will never see it.

7. Videos with no captions and PDFs that are scanned images

Think of your welcome video from the physician, your "what to expect at your first visit" walkthrough and the vaccine schedule you uploaded as a PDF. A video with no captions and no transcript gives deaf and hard of hearing patients nothing. A scanned PDF shows a screen reader a picture, and it reads nothing.

Patient forms are the worst offender. Patients are supposed to download a scanned intake packet, print it, fill it out and bring it in. Blind patients cannot use it. Neither can patients without a printer, or anyone on a phone. Rebuild these as real HTML forms. At the very least, make them tagged, text-based PDFs.

8. Heading structure that is really just big text

Open the page and look for its outline. There should be exactly one <h1>. Sections should use <h2>, and the subsections under them should use <h3>. Often the page builder let someone pick "Heading 4" because it looked the right size.

Screen reader users move through a page by jumping from heading to heading. If your headings are out of order, or your "headings" are paragraphs in a large font, that shortcut is gone. The page becomes a wall of audio. Search engines read the same outline, so a broken heading structure costs you rankings too.

9. Links that say "click here" and "learn more"

A screen reader can pull up a list of every link on a page, out of context. A list that reads "click here, click here, learn more, read more, here" tells the user nothing.

Every link should make sense on its own: "Request a newborn visit," "Download the sports physical form," "See our after-hours policy." That is also what Google wants your anchor text to look like.

10. An accessibility overlay widget in the corner

This one surprises people. That little wheelchair icon opens a panel of font sizes and color toggles. It fixes nothing underneath.

In practice it often breaks the assistive technology the user already runs. It does nothing about missing labels or broken keyboard navigation. Plaintiffs' attorneys treat it as a sign that the owner knew about the problem and bought a sticker in place of a fix. Hundreds of the lawsuits filed in recent years named sites that had one of these widgets installed. In 2025 the Federal Trade Commission went after one of the largest overlay vendors for claiming its product made sites compliant.

If you have one, spend that money on the other nine items.

What to do with this list

Go through your own site with this checklist before anyone else does. Most clinic websites fail at least six of the ten. Someone who knows the work can fix most of those six in an afternoon. Contrast, labels, alt text, headings and link text are content and template changes. None of them requires a rebuild.

Two of the ten, keyboard navigation and form errors, can take real work, depending on how the site was built. Ask your developer about those first. They are also the two that generate demand letters.

The federal rules behind all of this are in a separate note on website accessibility law for medical practices. A companion guide, how to fix an inaccessible medical website, walks through all ten in the order I would tackle them.