Physicians and the Americans with Disabilities Act (ADA)

Do state medical board applications violate the americans with disabilities act?  This question was asked by some academic individuals (Schroeder R, Brazeau CM, Zackin F, Rovi S, Dickey J, Johnson MS, Keller SE.) at UMDNJ-New Jersey Medical School, Newark, New Jersey. Here's what they found:

PURPOSE: To determine whether medical licensing board application questions about the mental or physical health or substance use history of the applicant violate the Americans with Disabilities Act (ADA) of 1990.

METHOD: Content analysis of 51 allopathic licensing applications (50 states and District of Columbia) was performed at the University of Medicine and Dentistry of New Jersey-New Jersey Medical School in 2005. Questions referencing physical or mental health or substance use were identified by a team of physicians and reviewed and categorized based on the ADA and appropriate case law by legal counsel.

RESULTS: Of the 51 applications reviewed, 49 (96%) contained questions pertaining to the physical or mental health or substance use history of the applicant. Thirty-four of the 49 (69%) state medical licensing applications contained at least one "likely impermissible" or "impermissible" item based on the ADA and appropriate case law.

CONCLUSIONS: Most state medical licensing applications contain questions that ask about the physical or mental health and substance use of physician applicants. Many licensing applications appear to be in violation of the ADA, even 19 years after enactment of the regulation. These questions do not elicit responses by which professional competence can be judged. The presence of these questions on licensing applications may cause physicians to avoid or delay treatment of personal illness.

PMID: 19474558

Schroeder R, Brazeau CM, Zackin F, Rovi S, Dickey J, Johnson MS, Keller SE. Do state medical board applications violate the americans with disabilities act? Acad Med. 2009 Jun;84(6):776-81.

Department of Family Medicine, Student Health and Wellness Center, and assistant professor, UMDNJ-New Jersey Medical School, Newark, New Jersey 07103, USA. schroers@umdnj.edu

Medical students with disabilities

Here's some information from the AAMC (Association of American Medical Colleges) about medical students who have disabilities:

The Americans with Disabilities Act (ADA) has afforded new rights and protections to persons with disabilities and heightened public awareness of the needs of this population. This handbook (published in 1993) provides an overview of the ADA and the antecedent Rehabilitation Act of 1973. It is intended to assist medical schools in the review and refinement of institutional policies. It is not intended as a comprehensive treatment of all the issues that might arise under the ADA or the Rehabilitation Act, no is it intended to provide legal advice. Schools should consult legal counsel regarding any specific questions about particular situations or decisions.

The purpose of the ADA is to provide opportunities for persons with disabilities to compete with other applicants on the basis of their ability. Like the Rehabilitation Act, the ADA requires many entities—including medical schools—to provide certain accommodations to persons with disabilities so that they may enjoy the same benefits, services and opportunities as those without disabilities. Schools must judge persons on the basis of their ability to complete the educational program rather than on their status as disabled persons. Persons seeking admission must be able to perform the "essential functions" or meet the "essential eligibility requirements" of the program once they have been provided with any needed accommodation or modification. Each school must determine the "essential functions" or "essential eligibility requirements" of its educational program. Preadmission inquiry as to whether a person is disabled is not permitted, but a school may seek as much information as is needed to make a determination that an individual can perform the "essential functions" or meet the "essential eligibility requirements" of the educational program.

In 2005, the AAMC published an updated version of this document, Medical Students with Disabilities: A Generation of Practice, which includes a discussion of ADA-related case law generated since the early 1990s.

You can read the full document here (PDF)

Accommodations for Medical Faculty With Disabilities

In 2002, there was an article in the Journal of the American Medical Association (JAMA) titled, "Reasonable Accommodations for Medical Faculty With Disabilities." Here's the abstract from that article:

An unknown number of medical school faculty have disabilities, and their experiences have generally escaped notice and scrutiny. Although most medical schools offer long-term insurance and extended leaves of absence for disability, relatively few have policies explicitly addressing accommodations for faculty with disabilities as they perform teaching, research, and clinical duties. We discuss accommodating active medical school faculty with disabilities, drawing on University of Pennsylvania School of Medicine initiatives exploring the concerns of faculty with sensory and physical disabilities. Anecdotal reports suggest that many faculty, fearing reprisals, resist seeking job accommodations such as those mandated in the 1990 Americans with Disabilities Act (ADA). Although some faculty with disabilities have found supportive academic mentors, others report that lax institutional enforcement of ADA requirements, including physical access problems, demonstrates a tepid commitment to disabled staff. Potentially useful job accommodations include adjusting timelines for promotion decisions; reassessing promotions requirements that inherently require extensive travel; improving physical access to teaching, research, and clinical sites; and modifying clinical and teaching schedules. Faculty with disabilities bring identical intellectual and collegial benefits to medical schools as their nondisabled counterparts. In addition, they may offer special insights into how chronic illness and impairments affect daily life.

This article was written over 7 years ago. How far have we come? Are we making progress in this area?

Reasonable Accommodations for Medical Faculty With Disabilities
Annie G. Steinberg, MD; Lisa I. Iezzoni, MD, MSc; Alicia Conill, MD; Margaret Stineman, MD
JAMA. 2002;288:3147-3154.

100 Days to the ADA (Americans with Disabilities Act)

Countdown to the 20th Anniversary of the ADA: Day 98 - Preparing the Workplace for Everyone: Emergency Preparedness for People with Disabilities in the Workplace

On April 19, 1995, the Alfred P. Murrah Federal Building in Oklahoma City was the site of domestic terrorism when it was bombed by Timothy McVeigh and Terry Nichols. Out of this senseless tragedy came legislation addressing the protection of federal buildings and workplaces. As we remember the events of that sad day, let us take the opportunity to ensure that in an emergency everyone - including individuals with disabilities - knows what to do and has been considered in the plan to get all occupants to safety.

Preparing the Workforce for Everyone
(http://www.dol.gov/odep/pubs/ep/preparing2.htm) provides guidelines that individuals, employers and emergency managers can use to create inclusive emergency preparedness plans for their workplace. Developed by an interagency council of federal agencies, the guide includes some of the best methods being used in the federal government to ensure that the needs of all individuals are considered during an emergency.