When the hearing loss is the doctor's

Bess Veyberman Herbert wanted to enter a line of work that presented an intellectual challenge and involved teaching and helping people. Not surprisingly, she decided to pursue a career in medicine. What is surprising is that Herbert, who now practices family medicine at Greece Medical Associates in Rochester, NY, and is on the faculty of the University of Rochester School of Medicine and Dentistry, is thriving in a profession where communication is key, despite the fact that she has a severe bilateral sensorineural hearing loss.

And she's not alone. Although statistics are hard to come by, advocates for the hearing impaired agree that the number of physicians with less-than-optimum hearing is growing-especially because the Americans with Disabilities Act (ADA) of 1990 mandates that employers (1) can't refuse to hire an otherwise qualified disabled person simply because he or she is disabled, and (2) must make "reasonable accommodation" for disabled employees-and for independent physicians on a hospital's medical staff-unless the employer can show that doing so would be financially onerous. Most states have their own ADA laws, and the amount of money employers are required to spend on disabled employees varies from state to state, but typical accommodations for employees with diminished hearing include telephone amplifiers, vibrating pagers, and special stethoscopes-items that are easily available to physicians in private practice or who don't otherwise qualify for ADA protection.

But being a hearing-impaired physician does present hurdles, Herbert acknowledges. She and similarly situated doctors have problems understanding announcements that are delivered via intercom. Likewise, amplification systems at conferences and other meetings might be inadequate. Everyday speech-particularly that of children and people with high-pitched voices-is difficult to discern. If the speaker's face can't be seen, background noise is present, or the lighting is poor, understanding speech is harder still. Many one-syllable words that begin with consonant sounds, including the numbers two and three, sound alike, so extra care has to be taken when patients describe their symptoms.

Overcoming an "invisible" handicap

No one expects someone who's visually impaired to read a telephone book or a wheelchair-bound person to get up and dance, but the expectation that hearing-impaired people can make out what other people are saying-if only they'd pay attention or try harder-is pervasive, even among those who should know better.

Rosanne J. Hooks, an FP in Mullins, SC, who has had moderate bilateral hearing loss since birth, points out that impaired hearing "poses no barrier to a physician. It's just a matter of coping. Too often, however, the unimpaired are unable to appreciate the extra effort that this coping takes, and tend to see it as a weakness or just complaining."

Those are among the principal reasons that many hearing-impaired physicians remain "in the closet," unwilling to tell patients and colleagues about their disability. One such closeted physician, an FP in the Midwest, recalls her own prejudices toward hearing-impaired individuals. "Ironically, before my diagnosis of moderate to severe high-frequency hearing loss, I felt people with hearing aids were either old or mentally slow-something I certainly don't believe now," she says.