Disabled doctors struggle with inclusivity, finds survey

by Tim Tonkin

‘I was told that “doctors don’t get sick”, making me feel weak and a failure at a time when I needed support.’

Location: UK
Published: Tuesday 11 August 2020
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This experience, reported by one doctor to a BMA survey of disabled doctors and medical students, paints a damning yet sadly not untypical experience of the kind of dismissive attitudes faced by many healthcare professionals in the NHS.

The survey, which was carried out between November 2019 and January this year, sought to shed greater light on the challenges and inequalities affecting disabled people by highlighting their experiences across a range of issues.

Incredibly, in a profession that places care giving and compassion at its heart, there appears to be a strong perception that medicine is frequently not inclusive in its approach to disability and ill health among those who practise it.

Of the more than 700 doctors and students responding to the survey, just 36 per cent reported feeling comfortable at the prospect of telling their employers or colleagues about their disability, because they believed their workplace or medical school was disability friendly.

Added to this was the fact that 77 per cent expressed fear of being treated unfavourably were they to reveal their health conditions, with just 41 per cent saying that doing so had resulted in them receiving improved support for their disabilities.

‘I felt I had to disclose information I did not wish to, and my trainers have felt it is reasonable, due to my health condition to behave in questionable ways such as questioning my capabilities,' one doctor told the survey.

‘Making judgements on my lifestyle outside of work, on my character and so on. They have used my health and disability as a weapon.’

Seniors targeted

Disability-related bullying or harassment is disturbingly common for doctors. It is more likely to be experienced among senior doctors with 42 per cent of consultants and 38 per cent of staff, associate specialist and specialty doctors reporting such experiences to the survey compared with 33 per cent of junior doctors and 24 per cent of students.

Challenges faced by disabled people in the work place can also be amplified by intersecting issues around ethnicity.
While 38 per cent of white doctors and students with a disability reported feeling comfortable in disclosing it, just 20 per cent of BAME (black, Asian or minority ethnic) doctors and students felt similarly.

Additionally, while 58 per cent of those from a white background said they had succeeded in obtaining adjustments for their disability, only 39 per cent of BAME staff said the same.

This must also be considered in light of the fact that only 55 per cent of survey respondents said they received reasonable adjustments, while just 26 per cent felt their workplace or schools' sickness absence policies took proper account of their disabilities or health condition.

For doctors and students with disabilities, access to flexible working is the single most significant adjustment sought for, with 57 per cent requesting this, compared with 11 per cent who require structural changes to a building.

Despite this, many report resentment and opposition from non-disabled colleagues, as outlined by one medical student taking part in the survey.

‘The first instinct of my educational supervisor was to tell me that she was worried I would not be able to cope or function as a consultant,’ says the student.

‘She didn't say why or how she thought I would have difficulty, or suggest any ways of helping me, or any changes to my work patterns, she was just letting me know I was unworthy.’

‘One consultant told me I only got into medical school on a disability quota,’ another doctor told the survey.

‘One refused to work with me because I needed a minor adjustment at work.’

Unaware of help

helena mckeown MCKEOWN: 'A system not designed with their needs in mind'

Despite the fact that NHS England’s recent Workforce Disability Equality Standard found the majority of trusts had disabled staff networks (63 per cent) in hospital and a disability champion (65 per cent), fewer than 10 per cent of doctors taking part in the survey said they were aware of these resources being available in their workplaces.

In presenting its findings, the BMA has also used its survey to set out a total of eight recommendations aimed at improving the day-to-day working and cross-career experiences of disabled doctors and students.

Among these are increasing awareness of disability in the workplace, by confronting discrimination and promoting positive and visible role models.

The association is also calling for trusts to create centralised budgets and simplified processes for funding reasonable adjustments, and to improve access to occupational health services for all doctors and students.

The BMA is also backing efforts to make career and training pathways more flexible, in part by utilising services such as telemedicine and remote working, both of which have proved invaluable during the pandemic, and by ensuing that sickness absence policies are updated to properly reflect the needs posed by disability or long-term ill health.

‘Disabled doctors and medical students are a valuable part of our medical profession, bringing unique perspectives and insight into patient experiences and healthcare,’ says BMA equality, diversity and inclusion advisory group chair Helena McKeown.

‘They also face unique barriers and challenges as they study, train and work in a system that was not designed with their needs in mind.’

Dr McKeown said that the survey findings, and more recently the pandemic, had emphasised the extent to which the health service both needed to reform ways of working to better serve and protect those with disabilities, while also demonstrating that effective change could be made with sufficient will.

‘The response to COVID-19 has also involved unprecedented changes to the way that health services operate and creates an opportunity to re-think healthcare delivery and job design,’ she says.

‘Some of the changes that happened at the peak of the virus show that things that disabled doctors and medical students have been calling for, for many years, such as more remote working opportunities, can in fact be implemented at large scale and at rapid pace, if the will is there to do so.’