The dual challenge of being a woman in medicine with a disability
Key Takeaways
Physicians often feel more comfortable accommodating patients with disabilities than colleagues with disabilities, revealing implicit biases about who "belongs" in medicine.
Female physicians with disabilities can provide an invaluable perspective shaped by their lived experiences, improving patient connections and medical education.
People with disabilities remain vastly underrepresented in medicine, despite making up 25% of the US population, signaling the need for more inclusive policies and attitudes.
Diversity in medicine means many things, but one thing that is often overlooked is the importance of adequate representation of HCPs with disabilities. And to be a woman in medicine with a disability is to face dual challenges stemming from this lack of representation.
Collaborating with colleagues with disabilities
Interestingly, physicians may be more comfortable interacting with their patients with disabilities than with their colleagues who are disabled.
In a recent educational session hosted by the AMA Medical Student Section, Davy Ran, MD, MSc, MPH, a physician with a disability, advised attendees, “If you don’t know how to act with an accommodation, just ask.”[]
Dr. Ran, who is an internal medicine resident at Montefiore Medical Center in the Bronx, NY, also pointed out, “There’s no shame in being disabled. That means there’s no shame in asking [colleagues] what it’s like to have a disability.”
This is an important point, as many of us in medicine have a tendency to try to ignore the disabilities of our colleagues, or to pretend those disabilities don’t exist. We do this for a number reasons, primarily tied to the social stigma of having a disability, such as a lack of understanding, a fear of making an offensive misstep, and similar. But pretending a colleague's disability doesn't exist delivers a double disservice:
First, it reinforces the belief that everyone should conform to one way of being, or "the norm,” which has been referred to as structural ableism.[] Secondly, it can shut down our colleagues’ ability to discuss their needs with us, potentially affecting their ability to advocate for themselves in the workplace.
Fresh perspectives
Diverse perspectives are a given when there is diversity among a clinic's staff of physicians. And fresh perspectives and different experiences from physician to physician ultimately translate to better quality care for all patients.
One of the presenters at the AMA Student Section session was Courtney Franz, a 3rd-year medical student at Texas Christian University's Burnett School of Medicine in Fort Worth, TX. She related how her experience having her leg amputated above the knee helped her connect with a patient who needed a life-saving amputation: The patient was reluctant to undergo the leg amputation, but Franz was able to speak from her own experience, ultimately telling him, “Your leg does not define who you are.”
Franz highlighted a key lesson from this encounter, one that she felt the patient’s physicians had missed: “This man was more afraid of losing a leg than losing his life. So always ask: Who is this patient beyond their medical conditions?”
Underrepresentation in medicine
Although more than a quarter of all Americans have a disability, only about 1 in 20 medical students, residents, and fellows has a recorded disability.[] Accordingly, a number of barriers still exist when it comes to inclusion and accommodation for HCPs with disabilities.
These barriers can include a lack of infrastructure or policy to allow medical professionals to report disability and request accommodations—which leads to nondisclosure of disability and added stress in an already stressful profession. Other barriers relate to poor or absent messaging on the topic of disability; lack of policy transparency; lack of education on relevant disability and case law; fear of retribution or loss of opportunities; and burdensome processes for seeking assistance and accommodation.
While the Americans with Disabilities Act has made progress in promoting equality, the culture of medicine has lagged behind in fully embracing its professionals with disabilities.
Many medical schools and hospital systems still lack robust policies and infrastructure to support the disclosure of disabilities and requests for accommodations. Furthermore, the demanding environment that continues to define medical training can foster ableist attitudes that result in dangerous prejudices, such as equating disabilities with weakness or an inability to handle the pressures of medicine.
All of these factors contribute to the striking underrepresentation of people with disabilities in medicine. And, regardless of whether or not they have a disability, all women in medicine should be able to empathize with the frustration of feeling unsupported and unrepresented in the profession as a whole.
What can you do?
Medical students and residents with disabilities who advocate for themselves and each other help lay crucial groundwork for more-inclusive policies. Senior physicians who publicly share their experiences of acquiring a disability during their career or progressing through training with an existing disability can help break down stigmas.
Non-disabled medical professionals have a duty to educate themselves on issues related to ableism, while making efforts to support the needs of colleagues with disabilities. Moving forward, the culture of medicine must shift to fully embrace the diverse perspectives and talents of people from all backgrounds and experiences.
Diverse representation brings richness to patient care, medical education, research, and innovation. The practice of medicine will see significant improvements once all HCPs recognize the necessity of championing disability inclusion.
What this means for you
You can take advantage of the opportunity to champion disability inclusion by educating yourself on ableism, by supporting colleagues' accommodations, and by consistently advocating for more-inclusive policies and attitudes. Creating a culture that welcomes professionals with disabilities (similar to your efforts to create a more welcoming culture for female physicians—and all women in the healthcare industry) will only enrich the medical field with diverse perspectives and talents.