Penn Initiative Leads to Survey of Faculty Members with Disabilities at Seven Medical Schools

(Philadelphia, PA) -- Doctors are among the first to recognize that physical disabilities can occur at any point in an individual's life, but even medical school faculty members facing the onset of such a disability often keep it secret for as long as possible, fearing discrimination from their colleagues and academic officials when it becomes known.

That concern underscores the experience and expectations of disabled medical faculty as they persevere in their careers with "a silent and lonely tenacity," according to findings of a paper to be published in the December 25 issue of the Journal of the American Medical Association (JAMA).

"Anecdotal reports suggest that many medical faculty members with disabilities decide against making their condition known because they fear reprisals, particularly the loss of professional opportunities such as tenured positions," said Annie G. Steinberg, MD, of the Department of Psychiatry at the University of Pennsylvania School of Medicine. Steinberg co-authored the study with Lisa I. Iezzoni, MD, MSc, of the Department of Medicine at Beth Israel Deaconess Medical Center and Harvard Medical School in Boston, Mass.

"Faculty members with disabilities bring a wealth of personal insight and experience to medical teaching, but they must be made to feel as welcome, comfortable and secure as their able-bodied colleagues. They are neither super-heroes nor more vulnerable than their peers, but only require legally-mandated accommodations to succeed, " Steinberg added. "Through the daily example of their lives, they may remind students, residents and attending colleagues that medicine is about more than diagnosis, treatment and cure -- it requires an understanding of chronic illnesses that affect 100 million Americans."

The research paper, which is being published as a "special communication" in JAMA, is an outgrowth of the Penn Initiative 2000 project to examine quality of life issues for the university's faculty. Steinberg, Iezzoni, and their colleagues broadened their original work to encompass seven medical schools throughout the country.

The findings raise questions of access and convenience for academic medical professionals with
disabilities as they function within a political and social context that the authors describe as increasingly
challenging. The 1990 Americans with Disabilities Act, for example, offers no specific accommodation standards but instead mandates "reasonable" efforts by employers that will cause them no "undue hardship," thus leaving room for various legal interpretations.

For the nation's medical schools, the resulting legal ambiguity is translated into a wide range of responses -- from supportive teaching environments to professional isolation. Often, disabled faculty face huge challenges that escape the notice even of sympathetic colleagues. One faculty member who uses a wheelchair told researchers she had to refrain from eating or drinking at a reception where she was the honoree because the auditorium where the function was held had no wheelchair-accessible restroom. Another said the head of her department will not offer her a tenure-track position out of concern that it would be too stressful, leaving her faced with a year-to-year contract.

According to the survey, disabled medical faculty want their institutions to move past those sorts of oversights and misplaced, sterotype-based concerns. They believe they could compete for promotions more successfully with limited changes in academic criteria, such as extended timelines for professional promotions and promotion criteria that de-emphasize extensive travel. They also believe they could benefit in their work from improvements in physical access to teaching, research and clinical sites, and the opportunity to modify their clinical and teaching schedules.

"Now that we recognize these needs, academic medicine's response to them will be a true indication of the values and empathy we offer as members of the healing profession," Steinberg said. "It will also be part of the legacy of example we will leave for those who come after us, and one real measure of how we, ourselves, can expect to be treated by medical professionals in the future."

Penn faculty also participating as researchers for the survey were Alicia Conill, MD, of the Department of Medicine, and Margaret Stineman, MD, FACRM, of the Department of Rehabilitation Medicine. The study was conducted through volunteer time and efforts.

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Penn Medicine is one of the world's leading academic medical centers, dedicated to the related missions of medical education, biomedical research, and excellence in patient care. Penn Medicine consists of the Raymond and Ruth Perelman School of Medicine at the University of Pennsylvania (founded in 1765 as the nation's first medical school) and the University of Pennsylvania Health System, which together form a $6.7 billion enterprise.

The Perelman School of Medicine has been ranked among the top five medical schools in the United States for the past 20 years, according to U.S. News & World Report's survey of research-oriented medical schools. The School is consistently among the nation's top recipients of funding from the National Institutes of Health, with $392 million awarded in the 2016 fiscal year.

The University of Pennsylvania Health System's patient care facilities include: The Hospital of the University of Pennsylvania and Penn Presbyterian Medical Center -- which are recognized as one of the nation's top "Honor Roll" hospitals by U.S. News & World Report -- Chester County Hospital; Lancaster General Health; Penn Wissahickon Hospice; and Pennsylvania Hospital -- the nation's first hospital, founded in 1751. Additional affiliated inpatient care facilities and services throughout the Philadelphia region include Good Shepherd Penn Partners, a partnership between Good Shepherd Rehabilitation Network and Penn Medicine.

Penn Medicine is committed to improving lives and health through a variety of community-based programs and activities. In fiscal year 2016, Penn Medicine provided $393 million to benefit our community.

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