Living with disabilities

Living with a disability is difficult, and physicians living with health issues face challenges in the workplace. Doctors who have either apparent or more hidden limitations have to adapt in order to be able to continue to do their work as physicians, often without the support of peers and colleagues. 

Lisa Meeks, PhD, MA, whose research is focused on improving access to medical education for learners with disabilities, says that work being done across the country highlights the benefits of diversity and inclusion in medicine. She has noticed, in general, that medicine is moving from limiting physicians with disabilities to being more supportive.

The word “disability”

Terminology is important, and words like “disability” can be upsetting or offensive to many people. “As a society we’re taught how to respond to language and terminology; we assign value and meaning to the words,” Meeks says. 

Amit Algotar, MD, a preventative medicine physician who is assistant professor at the University of Arizona and Banner University Medical Center in Tucson, Ariz., has spastic quadriplegia, requiring use of a manual wheelchair after an infection with viral encephalitis as a child. He says that the prefix “dis” has a negative connotation, which he doesn’t like. He uses the words limitations or impairments. “It only becomes a disability if the environment is not conducive,” Algotar says.

Stephanie Camaglia Reznick, MD, a primary care physician who practices telemedicine and teaches at Case Western Reserve University School of Medicine in Cleveland, Ohio, has recurrent inflammatory bowel disease, which has limited her ability to work. She says that she can understand why the term disability seems inherently judgmental, with the “dis” defining a lack of ability. But out of practicality, she uses the term as it is commonly used. “I am not one to be offended by the term disability,” Reznick says. 

Heather Finlay-Morreale, MD, associate professor of pediatrics at the University of Massachusetts Medical School, has chronic pain resulting from post herpetic neuralgia. She says that she doesn’t mind the terms disabled or handicapped. “That is what society uses,” she says. 

Strength or a weakness? 

Limitations interfere with a physician’s ability to work, but they can also provide assets as a doctor approaches all facets of work, including patient care. Finlay-Morreale explains that she has had to be creative and adaptable in how she structures her home and work life and has learned to set limits. She has developed self-care strategies ,which she describes as  mindfulness practice and a gratitude practice, which have greatly enriched her life “Without my post herpetic neuralgia, I probably would not have been led to these strategies,” she says.

As a result of her limitations, Reznick has gained advantages that have helped her as she cares for her patients. She says that having a disability or a medical condition as a physician is a double-edged sword. “Some patients with autoimmune conditions bond with me or trust me more because I have personal experience with the disease and I've been on both sides of the exam table," she says. 

Algotar says that there are practical drawbacks, explaining that in his case, his limitation would be a weakness in a surgical branch of medicine. But he does not think that his limitations are a factor in the care he provides to his patients. “I believe having limitations myself allows me to empathize and understand my patients better,” he says. 

How the medical community treats doctors with limitations

Society, and the medical community, often view doctors as more capable and healthier than the average person. In Reznick’s experience, patients and other physicians do not usually understand when a physician is sick or needs time off.  “There's this cultural belief that physicians are untouchable, shouldn't get sick, or should ‘suck it up’ and deal with it,” she says. In her patient care practice, she encountered resistance and even patronizing responses followed by a lack of any tangible changes when she requested accommodations such as bleach wipes in the examination rooms to reduce her chances of developing an infection. She is grateful for telemedicine, which has allowed her a way to continue to practice without exposure to infections. 

Finlay-Morreale has had a similar experience with high expectations for physicians. “Overall I think the medical profession and many doctors still think of the physician job as one for superheroes,” she says. She says that doctors are expected to have no weakness, no challenges, and no emotions. “This is unrealistic. We all have limits and we all need help at times. The field needs to get over this mentality as it is leading to burnout and suicides,” Finlay-Morreale says. 

Algotar, whose limitations are more visible, says that he doesn’t like to lump the entire medical profession as supportive or resistant to doctors with limitations because he has had both experiences navigating the graduate medical education process in the U.S. and in India, where he attended medical school. But he sees that overall, doctors with limitations are not welcomed into the medical field. “I can certainly say that institutions and graduate programs tend to be skeptical about doctors with limitations,” he says. He says that there are a lot more barriers that a doctor with a disability has to overcome to prove themselves and to get the respect they deserve. 

Advice for other doctors

Finlay-Morreale recommends that young doctors should be sure to get their own occupation disability insurance. “You never know what the future holds,” she says. Running a practice or working for a small group is more difficult in terms of sharing coverage and cutting back hours than it would be if working for a larger organization, she says. 

Reznick advises doctors who have limitations to adapt, but not to give up on medicine. “Do not be afraid to think outside of the box for solutions to challenges. The classic physician career path is not the only way to make good use of your degree and have a fulfilling career. Follow your heart and have faith,” she says.

And Algotar advises decision-makers to give individuals with limitations the same fair chance as other candidates. “National data suggests that average accommodations cost less than $500 per physician,” he says. He urges program directors and department chairs to consider the impact of having a physician with limitations. He shares a story of one of his patients who came to see him for an initial visit. “The patient told me, ‘I know this organization will take care of me, since I know it takes care of you,’” Algotar says. 

Meeks suggests that doctors find their network and know the resources available. “Search the hashtag #DocsWithDisabilities on twitter and connect with people with similar disabilities to see how they’ve successfully managed clinical medicine or medical education,” she says.