Leading with a disability

What does it mean to lead with a disability? Will I appear weak if I ask for accommodations?

I pondered these questions as it became apparent long COVID-19¹ would continue to affect me as I served as CFPC President. I asked similar questions when I wrote about mental health in 2019,² questions I thought I put to rest as I fought the stigma that often accompanies physicians asking for help.

Physician culture valorizes hard work, long hours, and self sacrifice. These attitudes were so pervasive during my early years of practice that it was not uncommon in our office lunchroom to hear my partners brag of coming to work extremely ill from infectious mononucleosis or working through evening clinics despite the agonizing pain of a newly broken ankle. How and when did physician work culture become so dysfunctional? Where does this pride in extreme self-sacrifice and working no matter what leave a physician who is unable to work in this manner?

Historically, the medical profession has not been welcoming to doctors with disabilities³ and the systems in which doctors work seem to be built on an ableist framework.⁴ Ableism is defined as the “belief system … that sees persons with disabilities as being less worthy of respect and consideration, less able to contribute and participate, or of less inherent value than others.”⁵ Call schedules are expected to be equally divided, and people are asked to find their own replacements when they are sick. Fierce independence in a system dependent on every individual doing their part can leave those who cannot keep up feeling they have no choice but to leave.

In the Canadian Medical Association’s 2021 National Physician Health Survey, 22% of physician respondents identified as having a disability.⁶ That is almost a quarter of our physician workforce. At a time when 6 million Canadians do not have a family physician,⁷ we need to do everything possible to ensure family physicians working with disabilities do not leave the profession because their unique needs cannot be accommodated. Simple adjustments are often all that are required. The focus needs to shift away from seeing accommodations as special treatment and toward understanding that optimizing working conditions allows for a healthy, fulfilled, sustainable workforce.

Such change is starting to happen. In 2022 The Ottawa Hospital’s Medical Advisory Committee unanimously voted for a position statement calling for improved conditions for physicians with disabilities, hoping to decrease systemic barriers for these physicians while acknowledging their lived experiences will be a benefit to the clinical environment and the institution overall.⁸ I have embraced my role as CFPC President knowing I will need to adjust as I go along, while feeling the support of the College’s executive team to do so. The commitment to equity and inclusivity at the CFPC has been part of what motivates me to share my experience. Having a disability as a physician can be an isolating experience. I am always here to listen, share, and advocate. Please reach out to me at cbernard{at}cfpc.ca.

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