A Survey of Family Medicine Department Chairs About Faculty With Disabilities: A CERA Study

摘要

Background and Objectives: Despite 21 million US adults having a disability, little is known about the types of disabilities among faculty in family medicine departments, accommodations used, or work limitations.Methods: We surveyed family medicine department chairs electronically about the number, types of disabilities encountered, accommodations and associated costs, and attitudes toward family medicine faculty with disabilities. This 10-item survey was part of the Council of Academic Family Medicine Educational Research Alliance omnibus survey. Data were summarized using descriptive statistics.Results: The survey response rate was 59% (88/148). Types of disabilities were reported for approximately 50 faculty members by 31 department chairs; only seven knew about the disability at hiring. The most common impairments were mobility, hearing, and mental health problems. Accommodations included adjusting schedules, additional time to meet tasks, and assistive technology. No additional costs were reported for accommodations by about one-third of respondents while costs were over $5,000 for approximately one-quarter. Most chairs reported that faculty performance was similar to peers without disabilities (42.2%) or adequate but not at the level of peers (40%); only one reported inadequate job performance. Faculty members with disabilities appeared to be accepted by peers, patients, learners, and staff, and only two faculty left their program because of the disability.Conclusions: Most chairs did not report experience with faculty members with disabilities. The disabilities encountered and accommodations were not unusual, but costs were sometimes high. While about half of chairs reported adequate or superior job performance for their faculty with disabilities, a sizeable minority judged such faculty to have poorer performance than peers despite reporting wide acceptance of faculty with disabilities by patients and colleagues. This study raises concerns about potential underreporting by faculty with disabilities and poorer perceived job performance despite wide acceptance and provision of accommodations, sometimes at high cost.(Fam Med 2015;47(10):776-81.)More than 21 million US adults, ages 18–64 years, have a disability.1 Disabilities include problems with mobility, hearing, vision, and cognitive function. Based on data from the 2003–2009 National Health Interview Survey, 26.7% of healthy-weight adults reported a disability.2 Among these adults, the most common forms of disability were movement (16.8%) and sensory difficulties (11.8%, including hearing and vision) followed by cognitive and emotional difficulties (2.9% and 2.4%, respectively). About one-quarter of respondents reported some limitation resulting from these disabilities. Work limitation was the most common, reported by 9.8%, followed by 6% reporting social limitations.Little is known about the prevalence of family medicine faculty members with disabilities, their types of disabilities, the accommodations they use, and/or the types of work limitations that they encounter. While it appears that <1% of medical school graduates report a physical or sensory disability (PSD),3,4 this small proportion is likely attributed to underreporting. While family physicians with disabilities should have access to accommodations under the Rehabilitation Act of 19735 and the Americans With Disabilities Act of 1990 (ADA),6 physicians appear reluctant to identify themselves as disabled or use available accommodations, in part out of fear of reprisal.7,8 In the study byNeal-Boylan and colleagues, 10 physicians with self-identified disabilities believed that having a PSD limited one’s career options and promotion trajectories.8 They rarely sought ADA-mandated workplace accommodations and thought that their interactions with colleagues reflected the administration climate and determined how welcomed they felt at work. Reported emotional reactions to workplace disability-