Dr. Kelli O’Laughlin is one of the women I most respect and admire on the planet. In addition to being a FemInEM and FIX17 speaker, she is my cousin. At our family dinners, she shows me how to balance being a mother, wife, and EM doc. She makes sure our family sets goals, and she keeps us to them. And when she tells me I should do something, I do it.
So when Kelli told me I should apply to speak at FIX18, I didn’t doubt that I should – I just didn’t know what to speak about. My amazing, inspiring, encouraging cousin had gone so far as to fill out my demographics on the online speaker submission form, but there was a glaring empty box waiting for me to enter my proposed topic.
I looked at Kelli and our husbands blankly – “I’m just a first year fellow,” I said, “I haven’t really done anything yet that’s worth talking about.”
“Why don’t you talk about being a doctor with one eye?” Kelli’s thoughtful husband, Drew, offered.
“But that doesn’t impact me at all.” I shot back. “Having one eye doesn’t make it harder for me to do my job.”
Thank you, Drew and Kelli O’Laughlin.
I spent that evening and the next 8 months planning how to share (with a bigger audience than I had ever addressed) why being different does not make me deficient. I will let you watch the talk to hear about my own experiences, but I wanted to share two lessons I’ve learned about the broader context of being different in America and in medicine:
First, that increasing diversity in America is not necessarily reflected in medicine. HRSA reported in 2008 that while about 25% of Americans were Black or Hispanic, only 9% of the physician workforce identifies as Black or Hispanic.1 The landscape is similar for disability in medicine: the CDC reported in 2018 that about 25% of US adults live with a disability.2 However, only 2.7% of medical students from U.S. MD-granting programs self-reported a disability to their institutions (compared to 7.6% of graduate students and 11.1% of undergraduates).3 Trends in workforce diversity in medicine are slowly adjusting to reflect those in the general population, but despite gains, the gap is widening between the patients we serve and who we are as doctors.
Second, diversity in medicine does not mean worse, and often means better. There is abundant data to suggest that minority physicians and women are more likely to practice in underserved communities and that racial and ethnic concordance in the physician-patient relationship results in higher patient satisfaction.4 Similarly, anecdotal reports in the popular press suggest that in the future we may see similar improvement in patient satisfaction with greater availability of physicians with disabilities.5
The American medical community has made great gains in our recognition that physicians of all gender identities, backgrounds, and physical abilities can provide excellent care, but we still have work to do. As medical professionals in pediatrics and in emergency medicine, our goal should not be to tolerate diversity, but to celebrate it.
See you at #FIX19,
Dr. Elyse Portillo, the one-eyed otter
Watch her FIX18 talk below!
- US Department of Health and Human Services: Health Resources and Services Administration. The Physician Workforce: Projections and Research into Current Issues Affecting Supply and Demand.; 2008. Accessed February 1, 2019
- Centers for Disease Control and Prevention. CDC: 1 in 4 US adults live with a disability | CDC Online Newsroom | CDC. Accessed February 1, 2019.
- Meeks LM, Jain NR. Accessibility, Inclusion, and Action in Medical Education Lived Experiences of Learners and Physicians With Disabilities.; 2018. Accessed February 1, 2019.
- Cohen JJ, Gabriel BA, Terrell C. The Case For Diversity In The Health Care Workforce. Health Aff. 2002;21(5):90-102. doi:10.1377/hlthaff.21.5.90.
- Khullar D. Doctors With Disabilities: Why They’re Important. The New York Times. Published 2017.