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October is disability awareness month, and Labor Secretary Alexander Acosta kicked it off by noting the strong gains individuals with disabilities have made in employment.
This is great news for professionals in health-care fields, as they too are benefiting from growing workplace diversity and inclusion. A large network of doctors with disabilities, for example, is gaining visibility in hospitals and physician practices.
Some doctors with disabilities are sharing their stories on Twitter at #docswithdisabilities, increasing awareness of their contributions to improving health care. They are, at the same time, whittling away at discrimination borne out of a skepticism about their ability to do the job.
The progress has been slow, but steady, Lisa Meeks, a University of Michigan Medical School professor who does research in the area, told Bloomberg Law.
The increase in doctors with disabilities of all types can be attributed to a combination of awareness and numbers, Meeks said.
People with disabilities are making their voices heard, so more people throughout the country are aware of this population. Also, there is a huge “wave” of students with disabilities coming up through colleges and universities nationwide, broadening the pool of medical school applicants, Meeks said.
At the same time, barriers to medical school admissions appear to be falling. Meeks co-authored a 2016 study that found 2.7 percent of medical school students have disabilities. Seeing other people with disabilities who have succeeded at practicing medicine also is a big driver for people entering the profession, Meeks said.
There is no comprehensive study showing how many physicians with disabilities are practicing throughout the country, Meeks said. There is data that is divided between types of specialties and categories of disability, but nothing that looks at all categories of disabilities across all practice specialties, she said.
It could be difficult to trace, in any case, because not all doctors with disabilities ask for accommodations. Some don’t require an accommodation, while others “self-accommodate,” using techniques they acquired while in medical school, Meeks said.
The numbers of doctors with disabilities also is increasing because hospitals and physician practices are becoming more aware of their legal obligations to physicians, as well as to patients with disabilities, she said.
There is a trend in some areas of the country for hospitals to employ doctors. More traditionally, doctors are independent contractors who must apply to a hospital for medical staff privileges or credentials.
A doctor’s status, however, shouldn’t make any difference when it comes to disability rights law. Title I of the Americans With Disabilities Act applies to employer/employee relationships, but other sections of the law apply more broadly.
Titles II and III, for example, require “public accommodations” to be accessible to all users, Elisa Laird-Metke told Bloomberg Law. Private and public hospitals are considered public accommodations. Laird-Metke is an attorney and the director of the Disability Resource Center at Samuel Merritt University. The university is a Sutter Health affiliate.
As a result, the ADA’s requirements apply whether a doctor with a disability is employed or not, Christi Swick, an employer-side attorney with extensive knowledge of disability-related employment issues, told Bloomberg Law. Swick is counsel at Sandberg Phoenix & Von Gontard PC in Edwardsville, Ill.
Three federal appeals courts, the Fifth, Ninth, and Tenth, have said independent contractors may sue under Section 504 for disability discrimination, according to Laird-Metke. The U.S. Court of Appeals for the Eighth Circuit has said otherwise, meaning there is a circuit split on the issue.
The ADA generally requires health-care providers to make “reasonable accommodations” for doctors with disabilities. An accommodation is reasonable if it doesn’t cause an “undue hardship,” she said.
The requirements kick in during the application process, Swick said. Health-care employers may not ask an applicant about a disability, but they can ask whether the applicant is able to perform the “essential functions” of the job with or without an accommodation.
If an applicant or employee can perform the job’s essential functions with an accommodation, the employer must take affirmative steps to provide it. An accommodation could entail enlarging a work space so it is accessible to someone in a wheelchair or acquiring adaptive computer technology.
The argument that an accommodation “costs too much” usually doesn’t work as an undue hardship, especially when a court looks at an employer’s overall resources, Swick said. An accommodation that requires reallocation of tasks among other employees, on the other hand, would be problematic, she said.
Meeks encourages providers to hire doctors with disabilities because they improve health care in many ways. Just by virtue of their own experiences, these doctors are better equipped to understand and empathize with patients, especially patients with disabilities, she said.
Doctors with disabilities also have prompted innovative thinking about how to provide care, and suggested improvements to existing technologies. These contributions, taken together, should help industry stakeholders thrive in a value-based reimbursement system.
The doctors “have a unique opportunity to challenge existing beliefs about people with disabilities simply by being in the room,” Meeks added.
“By witnessing their peers in action, other physicians may change their perceptions regarding the abilities of individuals with disabilities, removing presumptions about lifestyle or quality of life that falsely inform health-care decisions and treatment,” she said.
Stereotypes and stigma have created barriers to physicians with disabilities. Those barriers, however, are being overcome, Meeks said.
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