Episode 19: AMA Organizational Strategic Plan to Advance Health Equity

Collection IV: policies towards disability inclusivity in the health sciences.

Article or Publication discussed: AMA’s

Authors: AMA (2024-2025)

Citation: “AMA Organizational Strategic Plan to Advance Health Equity 2024-2025.” 2024. American Medical Association. June, 2024. https://www.ama-assn.org/about/leadership/ama-s-2024-2025-strategic-plan-advance-health-equity.

Description: Research and Resource Rounds Episode 19 launches Collection IV: policies towards disability inclusivity in the health sciences. The episode examines how the AMA's 2024-2025 Organizational Strategic Plan to Advance Health Equity integrates disability consciousness into its vision for healthcare transformation. The 2024 Plan builds on the foundation laid by AMA's (original) 2021 Strategic Plan. Both plans explicitly name ableism and racism as interconnected systems of oppression. The episode provides an overview of the 2024 strategic plan, including of the five strategic approaches towards health equity identified in the plans: embed equity, build alliances and share power, ensure equity in innovation, push upstream, and foster pathways. The AMA's plan and associated resources show notable progress since 2021, including the establishment of a disability employee resource group, educational partnerships including disability-focused modules on the AMA Ed Hub by the Docs With Disabilities Initiative, and policy adoption on organ transplant equity and barriers in medical education for disabled trainees.

Producer: Zoey Martin Lockhart, Lisa Meeks

Audio Engineer: Jacob Feeman

Transcript: https://docs.google.com/document/d/1xWcJBRtUFh4HIncv3ITe6TAk8ym8GMyd/edit

Release: June 2025

Episode 18: “Physicians’ Perceptions Of People With Disability And Their Health Care.”

Collection III: Disability in health sciences: the need for and benefits of inclusion

This collection features studies and testimonials that examine the current state of disability representation among health sciences students and professionals and that demonstrate how the presence of disabled healthcare practitioners and trainees benefits both patients and clinicians/trainees.

Key works in this emerging literature are gathered in this cluster that includes qualitative studies, the results of quantitative data analyses, and personal testimonials.

Title of Featured Article: “Physicians’ Perceptions Of People With Disability And Their Health Care.

Authors: Lisa I. Iezzoni, Sowmya R. Rao, Julie Ressalam, Dragana Bolcic-Jankovic, Nicole D. Agaronnik, Karen Donelan, Tara Lagu, and Eric G. Campbell

Link: https://www.healthaffairs.org/doi/10.1377/hlthaff.2020.01452

Description: In their pioneering study, the authors’ project sought to understand physicians’ attitudes on people with disability, including physicians’ comfort treating these patients or welcoming them into their practices. Results show that many physicians lack confidence in providing equivalent quality care to disabled patients and non-disabled patients and that a vast majority (82.4%) of doctors believed that significantly disabled people have a worse quality of life–a sentiment contrary to the experiences and responses of many disabled people. Yet, encouragingly, nearly 80% of physician respondents also expressed the importance of understanding disabled patients. The authors suggest that the substantial explicit disability bias expressed by respondents is rooted in inadequate and inaccurate education about disability and disabled people in medical education and argue for improved training and evaluation of biases among key triage teams and medical decision-makers.

Producer: Zoey Martin Lockhart, Lisa Meeks

Audio Engineer: Jacob Feeman

Transcript link: https://docs.google.com/document/d/1rk1Kk5oJ4tetma1pumYmobiFuHrS8ERs5qxK7o9dkAA/edit?usp=sharing

Keywords: Patients with Disability / disabled patients, Ableism

Medical Education, Implicit bias, Disability attitudes, DocsWithDisabilities, Disability

Patient Care

Collection III: Disability in health sciences: the need for and benefits of inclusion

This collection features studies and testimonials that  examine the current state of disability representation among health sciences students and professionals and that demonstrate how the presence of disabled healthcare practitioners and trainees benefits both patients and clinicians/trainees.

Key works in this emerging literature are gathered in this cluster that includes qualitative studies, the results of quantitative data analyses, and personal testimonials.

Title of Featured Article: Being on Both Sides’: Canadian Medical Students’ Experiences With Disability, the Hidden Curriculum, and Professional Identity Construction

Collection III: Disability in health sciences: the need for and benefits of inclusion

Authors: Erene Stergiopoulos, Oshan Fernando, and Maria Athina Martimianakis

 Article Link: https://pubmed.ncbi.nlm.nih.gov/29794527/

Episode Link:  https://bit.ly/DWDI_RR_17

Description: Stergiopoulos’, Fernando’s, and Martimianakis’ research article investigates how medical discourses shape the conceptualizations of the prototypical “good medical student” and “good patient” roles as featuring mutually exclusive characteristics. They explore how disabled medical students’ experiences during training and professional identity construction are shaped and hold complexity as students navigate positions in both these roles—as both patients and medical trainees. The authors drew on critical discourse analysis to analyze text and interviews, developing codes informed by academic work on the Hidden Curriculum and professional identity construction. Results show that the dominant portrayals of the “good student” and “good patient” roles, robustly and vividly constructed by medical discourse, are juxtaposing and mutually exclusive.

Producer: Zoey Martin Lockhart, Lisa Meeks

Audio Engineer: Jacob Feeman

Transcript

Release: Feb 2024

Keywords:

Medical students; Patient role; Wellbeing; Medical School; Disability Inclusion; Patient Care

DSM; Psychiatric Illness; Mental Illness; Mental Health; Disclosure; Ableism; Medical Education 

Learning Disabilities; Medical culture; Culture of Medicine; Diversity in Medicine; Disability Education

Title: Ethical and Public Health Considerations for Integrating Physicians with Mental Disability into the Physician Workforce. 

Collection III: Disability in health sciences: the need for and benefits of inclusion

Authors: Amalia Sweet, Omar Sultan Haque, and Michael Ashley Stein

Description: 

Sweet, Haque, and Stein’s article explores questions of and argues for increased support and inclusion of physicians with mental disability. Grounding their work in the framework of intersectional social justice, the authors examine medical cultural factors, safety questions, and logistics. They conclude that greater representation of and support for mental disability in medicine will increase the quality and culture of medicine. The article outlines unfair, unnecessary, and discriminatory barriers currently faced by physicians and trainees with disability, to show inclusion and engaged support of physicians and trainees with mental disability is an issue of intersectional social justice. Efforts to increase the diversity of the medical workforce often focus on race and gender, skipping over disability as a dimension of diversity. When disability is considered, the extra stigma and incorrect assumptions surrounding mental disability can mean that people with these disabilities are overlooked or even specifically excluded. Meanwhile, the authors demonstrate that medical education, medical culture, and patient care would benefit from greater numbers of physicians with mental disability and are under-served when these people are excluded from practice or not properly accommodated.

Producer: Zoey Martin Lockhart, Lisa Meeks

Audio Engineer: Jacob Feeman

DOI:  https://doi.org/10.1017/jme.2023.24.

Journal link: https://www.cambridge.org/core/journals/journal-of-law-medicine-and-ethics/article/abs/ethical-and-public-health-considerations-for-integrating-physicians-with-mental-disability-into-the-physician-workforce/B0F4C6CE019E648081F59AD928A15EF2

Transcript: https://docs.google.com/document/d/1UPF9WaE9qrQmrmywfd465jZHGd8n1uER3AXlL6BdSdw/edit?usp=sharing

Release: Dec 2023

Keywords:

Mental Disability

Disability Inclusion

Patient Care

DSM

Psychiatric Illness

Mental Illness

Mental Health

Neurodevelopmental Disability

Neurodevelopmental Disorders

Learning Disabilities

Medical culture

Culture of Medicine

Diversity in Medicine

Disclosure

Professionalism

Competency

Clinicians

Clients

Ableism

Disability Education

Disability Attitudes

Disability Competency

Healthcare Training

Medical training

Care work

Chronic Illness

Disability terminology

Disability studies

Medical model

Health Sciences

Medical Education

Description: Episode 15 discusses “‘Yourself in all your forms’: A grounded theory exploration of identity safety in medical students” (Bullock et al. 2023). Bullock and his colleagues develop a theory of identity safety through careful analysis of 16 in-depth interviews with 3rd and 4th medical students with a diverse range of identities and experiences. The article identifies and describes key dimensions of identity threat, threat mitigation, and identity safety. Three factors contributing to identity safety that emerged from the team’s analysis: Agency to serve, upholding personhood, and a sense of belonging. Identity safety manifested as students sharing a particular minoritized identity with their attending physician, wearing a particular item or hair style, presenting themselves in a particular way, or feeling respected as unique individuals by both their peers and supervisors. When experiencing identity safety, students felt empowered to draw on their own unique experiential knowledge grounded in their particular identities when treating a patient.

Authors: Justin Bullock, Javeed Sukhera, Amira del Pino-Jones, Timothy G. Dyster, Jonathan S. Ilgen, Tai M. Lockspeiser, Pim W. Teunissen, and Karen E. Hauer.

DOI: https://doi.org/10.1111/medu.15174

Journal link

Transcript

Title of Featured Article: Professionalism and Disabled Clinicians: The Client’s Perspective.

Collection III: Disability in health sciences: the need for and benefits of inclusion

Authors: Tal Jarus, Roberta Bezati, Sacha Trivett, Michael Lee, Laura Yvonne Bulk, Alfiya Battalova, Yael Mayer, Susan Murphy, Patricia Gerber, and Donna Drynan.

Description: Episode 14 is the second of two sister-episodes exploring perceptions of disabled clinicians from a range of specialties. The article featured, "Professionalism and Disabled Clinicians: The Client’s Perspective" (2020) analyzes how disabled clients and caregivers of people with disabilities responded to the prospect of being treated by a disabled clinician. Drawing on interviews and focus-group discussions, the authors find that clients held positive perceptions of and were affirmative about receiving care from disabled clinicians. Interviewees felt that these providers might be more “client-centered,” could act as “role models,” 

Client interviewees also suggested that power dynamics between clients and clinicians (usually weighted towards the healthcare provider) might be evenly balanced in the case of disabled clinicians, not because disability lowered the social status of the provider but because the clinicians' additional experiential knowledge of navigating the world with disability would imbue the clinical encounter with enhanced rapport and understanding of barriers (on the part of the physicians). Interviewees felt that disclosure of disability by a provider fell into the realm of appropriate and professional interactions with clients–and could even enhance provider-patient relationships. A consensus also emerged that disabled clinicians would pick fields and work conditions that suited their strengths; clients felt safe being treated by clinicians with disabilities.

Producer: Zoey Martin-Lockhart and Lisa Meeks

Sound: Jacob Feeman

DOI: https://doi.org/10.1080/09687599.2019.1669436

Journal link: https://www.tandfonline.com/doi/abs/10.1080/09687599.2019.1669436?journalCode=cdso20

Transcript

Release: August 2023

Keywords:

Disclosure

Professionalism

Competency

Clinicians

Clients

Ableism

Disability Education

Disability Attitudes

Disability Competency

Healthcare Training

Medical training

Care work

Chronic Illness

Disability terminology

Disability studies

Social model

Medical model

Health Sciences

Medical Education

Title of Featured Article: ‘I Can Understand Where They’re Coming From’: How Clinicians’ Disability Experiences Shape Their Interaction With Clients. (2020)

Collection III: Disability in health sciences: the need for and benefits of inclusion

Authors: Alfiya Battalova, Laura Bulk, Laura Nimmon, Rachelle Hole, Terry Krupa, Michael Lee, Yael Mayer, and Tal Jarus

Description: This is the first of sister-episodes exploring perceptions of disabled clinicians from a range of specialties. The article featured in this episode, 13, draws on the experiences of clinicians and trainees with disabilities via analysis of qualitative interviews. The authors find that clinicians’ insider, experiential knowledge of living with disability or chronic illness—and of navigating health care as a person with disability—facilitates better care to disabled and chronically ill clients for several reasons: improved rapport; deeper listening, understanding, and empathy; and an understanding of barriers to good care that exist inside and outside of healthcare that is grounded in professional and person experience. Precise concordance of diagnosis or experience did not appear to be necessary. This paper suggests that the experiences of disability and chronic illness that motivate professional medical trainees to engage in educational disability advocacy are themselves experiences that provide professionally valuable expertise. 

DOI: https://doi.org/10.1177/1049732320922193.

Journal link: https://journals.sagepub.com/doi/10.1177/1049732320922193

Transcript: https://docs.google.com/document/d/1ckx2wzDejugQTRFP88cGaBk4mG1yN7gW/edit

Release: August 2023

Keywords:

Disclosure

Professionalism

Competency

Ableism

Disability Education

Disability Attitudes

Disability Competency

Healthcare Training

Medical training

Care work

Chronic Illness

Disability terminology

Disability studies

Social model

Medical model

Health Sciences

Medical Education

Transcript: https://docs.google.com/document/d/1SBOWRq1Kq9WiegnJMvlJMUDDuj9xOBcRsXgW7MkQRtQ/edit?usp=sharing

Title: ADEPT-CARE: A pilot, student-led initiative to improve care for persons with disabilities via a novel teaching tool

Collection II: Integrating disability into health sciences curricula: implementation, recommendations, and the need for disability content in health sciences education 

Article: “ADEPT-CARE: A pilot, student-led initiative to improve care for persons with disabilities via a novel teaching tool.” (2023)

Authors: Lydia Smeltz, Sandra Carpenter, Lauren Benedetto, Nora Newcomb, Dana Rubenstein, Tonya King, Christopher Lunsford, and Ami L. DeWaters. 2023.

Description: This article describes the student-led development and piloting of a didactic tool intended to assist medical trainees’ and providers’ capability and confidence when interacting with disabled patients in clinical environments. ADEPT-CARE is a mnemonic for which each letter corresponds to a distinct dimension of clinical process or behavior that experts recommend following when interacting with disabled patients. The tool was introduced to a group of first-year medical students. While their feelings of competence in treating disabled patients did not change after a 15-minute asynchronous video training on the ADEPT-CARE protocol–possibly due to the small sample size–the student participants did endorse the utility of the protocol.

DOI: https://doi.org/10.1016/j.dhjo.2023.101462.

Journal link: https://www.sciencedirect.com/science/article/abs/pii/S1936657423000298

Transcript: https://docs.google.com/document/d/1Ww_U_TbTpjPwaovW3E2vQTagK5E04x53/edit

Release: June 2023

Keywords:

Disability Education

Disability attitudes

Disability Competency

Healthcare training

Medical training

Care work

Chronic Illness

Disability terminology

Disability studies

Social model

Medical model

Health Sciences

Medical Education