This paper examines the use of touchscreen smartphones, focusing on physical access. Using interviews and observations, we found that participants with dexterity impairment considered a smartphone both useful and usable, but tablet devices offer several important advantages. Cost is a major barrier to adoption. We describe usability problems that are not addressed by existing accessibility options, and observe that the dexterity demands of important accessibility features made them unusable for many participants. Despite participants' enthusiasm for both smartphones and tablet devices, their potential is not yet fully realized for this population.