COMMENTARY

We Need More Doctors With Disabilities

Kenneth W. Lin, MD, MPH

Disclosures

August 21, 2017

Editorial Collaboration

Medscape &

Hi. I'm Dr Kenny Lin, a family physician at Georgetown University Medical Center in Washington, DC, and I blog at Common Sense Family Doctor.

When I purchased my current disability insurance policy after completing my fellowship training, my financial advisor pointed out that the policy was "occupation specific"—that is, I would receive payments if I suffered any injury that prevented me from practicing family medicine, even if I was able to transition to another income-generating career. Healthy and still in my twenties, it was then hard for me to imagine becoming disabled from doctoring but still able to pursue another occupation. Perhaps an injury that affected my eyesight or hearing, he suggested, or impaired my speech or ability to move my arms and legs.

Although it was brief and a long time ago, this discussion stayed in the back of my mind. When general practices relied on house calls to pay the bills, and there was little technology to support the doctor beyond what he or she could carry in a small black bag, a physical disability could easily have been disqualifying to practice medicine. But most doctors today are hospital- or office-based, telehealth visits are becoming increasingly common,[1] and nearly all basic diagnostics are available as apps or portable devices that can be used with smartphones.[2]

In an article published in Slate,[3] Nathan Kohrman argued that it no longer makes sense to discourage people with disabilities from becoming doctors. Although nearly one fifth of the US population has some kind of disability, less than 3% of medical school enrollees do, which, Kohrman pointed out, "makes them one of the most underrepresented groups in American higher education."

When admissions officers talk about recruiting a diverse medical student body, they are usually referring to characteristics such as race, socioeconomic status, gender and gender identity, and sexual orientation.[4] We know that underrepresentation of certain groups within the physician population contributes to health disparities in the general population.[5]

This may be the case for persons with disabilities also, as Dr Dhruv Khullar has observed[5]:

People with disabilities are less likely to receive routine medical care, including cancer screening, flu vaccines and vision and dental exams. They have higher rates of unaddressed cardiovascular risk factors like obesity, smoking and hypertension.

In a reflective essay in Health Affairs,[6] Dr Leana Wen described an incident during her emergency medicine residency when a senior resident misunderstood and ridiculed a stuttering patient. Dr Wen's own experience as a person who stutters was critical to her being able to diagnose the patient as someone who was not actually having chest pain but was simply struggling to overcome his disability in a pressured situation. Not only was Dr Wen able to later educate her senior resident about appropriate behavior toward patients with disabilities, but she also put together a seminar for other medical trainees.

It is important to sensitize all medical trainees to obstacles to care that persons with disabilities face, but it's even more important to recognize that doctors with physical disabilities can themselves contribute positively toward removing these obstacles.

A friend and medical school classmate of mine is hearing-impaired. She was fine in one-on-one conversations but had a harder time understanding speech in large lecture halls. I remember that she needed to approach each of our preclinical lecturers to ask them to use a special microphone, and she used an amplified stethoscope on her clinical rotations. She graduated with honors and is now a pediatric otolaryngologist. The world would be better off if we had more doctors like her, and that will only happen if medical schools actively recruit doctors with disabilities.

This has been Dr Kenny Lin for Medscape Family Medicine. Thank you for listening.

Follow Dr Kenny Lin on Twitter @kennylinafp

Follow Medscape on Facebook, Twitter, and Instagram.

Comments

3090D553-9492-4563-8681-AD288FA52ACE
Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.
Post as:

processing....