OMA launches new resource outlining accommodations required under the Human Rights Code
October is disability employment awareness month in Canada, providing an opportunity to celebrate the inclusion of physicians with disabilities in the workplace and to bring awareness of the need for inclusive work practices.
We’re sharing the story of Dr. Michael Quon, who was on a cycling trip in Colorado with friends almost a decade ago when a high-speed crash resulted in a traumatic brain injury and halted the start of his career as a doctor.
Dr. Quon spent more than a year trying to get back to work after his accident. The disability challenged his working memory. He had to take more notes and sometimes ask for questions to be repeated. He needed longer to process information and more rest between tasks. He had sensory challenges that made loud, busy environments almost intolerable.
OMA launches new resource outlining accommodation rights under the Human Rights Code.
But although intensive rehab, occupational therapy, speech therapy and psychotherapy had prepared him to return to work, as a doctor with a disability, he experienced a shocking lack of support and resources.
Today, Dr. Quon is working as a general internal medicine specialist at The Ottawa Hospital and is an advocate for physicians with disabilities or impairments.
He helped The Ottawa Hospital develop the first policy at any academic hospital in Canada focused on accommodating physicians with a disability. He criticized a new U.S. national plan for health workforce well-being for not addressing the needs of health-care workers with disabilities in a piece published in JAMA. He was since invited to co-chair the Recruit and Retain an Inclusive Workforce Working group for the Royal College’s National Plan for Health Workforce Well-Being. His advocacy with the OMA helped advance the development of their new resource to improve the understanding of work accommodations.
Dr. Michael Quon is a general internal medicine specialist at The Ottawa Hospital who overcame a traumatic brain injury to return to work. He’s now an advocate for physicians with disabilities and committed to creating a more inclusive work environment for doctors across Canada.
Here’s what he wants doctors with or without disabilities to know:
Q: What’s your work life like today?
A: I'm quite thankful to the division head who brought me on at The Ottawa Hospital because he was considerate and inclusive. It was not something that everybody would have done, and I’ve encountered physician leaders who were not willing to accommodate even a different schedule for me. I know now that that’s discrimination.
When I'm at work, I’m able to give 100 per cent toward optimizing my patient care. I've naturally adjusted, and I work in a hospital that has a quiet office for me to do the charting and provide space when I need it. I modify my work schedule between desk time and clinics with patients, so I’m not taking on too much cognitive load all at once. Overall, I have an effective strategy to minimize my symptoms during the daytime.
Q: You believe ableism is entrenched in the culture of medicine. Why do you think that is?
A: By history and by culture, there's this superhero image attached to physicians, especially in training environments. There are excessive demands on your life to become a physician and then, often excessive work hours and work volume in practice. There's sort of this ‘grind culture’ in doing that and not complaining. It’s almost seen as a badge of honour.
Then you have people who cannot do it, and they may be seen as lesser because they need to do things differently. It's often seen as a weakness because of the glorification of the grind culture. And that's essentially ableism, where the people who have impairments are devalued, and that can lead to a lot of discrimination against them.
Q: What are the implications for the health system if it’s not inclusive for doctors with disabilities?
A: We don’t have precise data, but we can estimate that at least three to five per cent of the population has a disability – that’s thousands of doctors across Canada. Addressing barriers to the workforce for physicians with disabilities is more critical now than ever. We have a physician workforce crisis, people can't access care, and we have an aging population. The physician population is aging too and there’s going to be a growing number who develop or acquire disabilities. It’s critical to the system that we have as many physicians as possible contribute to patient care.
There's this superhero image attached to physicians, especially in training environments. There's this glorification of the 'grind culture,' and when people need to do things differently, it’s often seen as a weakness. That’s essentially ableism.
Q: Are physicians required to disclose a disability to an employer or a patient?
A: Disclosing to patients is not necessary by any means. Work accommodations allow physicians with disabilities to provide excellent patient care. If you can do the job in an accommodated way, there's no need to share your medical information, which is confidential, with your patients. Some doctors might share their experiences to create a bit more of a bond or understanding with the patient. But, ethically, there's no requirement. There is also no legal requirement to disclose to your employer if you can do the job effectively.
Where the law plays a role is in requiring employers or workplaces to accommodate physicians with disabilities. It’s protected by the Ontario Human Rights Code. This is not widely understood by the medical profession. Accommodation is sometimes seen as a choice or a consideration. But it's the law.
Q: How should doctors with disabilities approach health-care institutions and leaders about work?
A: It’s definitely a big concern among people with disabilities; many physicians are uncomfortable. There's so much stigma and potential for discrimination that people see a lot of risk in disclosing impairments. I'm being public and sharing my experience because as a medical society, we need to normalize that doctors get sick and have disabilities and normalize a more accommodated, accessible culture.
Q: How would you recommend doctors have a conversation in workplaces about their disability?
A: I remind people that there’s potential value added to their contributions because of their disability. For one, you have significant patient experience, and so you have a better understanding of the challenges that patients may face. That valuable insight can potentially improve the quality of care for patients. Additionally, there's more and more interest in physician wellness and well-being, as well as physician equity and inclusion. Because of your lived experience, you can take on leadership roles in these domains. Even if not in a leadership role, your experience can add value and unique perspectives to your physician group and the patients that you care for. That’s attractive to physician leadership who want inclusive workforces and people with different experiences.
Q: What would you say to physicians with disabilities who are struggling at work?
A: First I would say, you’re not alone. There are opportunities to connect to other physicians with disabilities. The Canadian Association for Physicians with Disabilities is one avenue. It was helpful for me to connect with others who have had similar experiences and to learn from them. The other big thing I’d like to do is empower people with disabilities. You have a human right to be accommodated in your workplace and you should be.
Continuing in an unaccommodated way can be even more impairing to your health and ability to practice. It's critical that you work towards an accommodated work environment because we need you in the workforce and we need your unique insights for your patients, physician groups and organizations.