As part of its broader efforts to advance health equity, the AMA is stepping up its advocacy alongside patients and physicians with disabilities. That includes addressing ableism, which is “a system of power that classifies entire groups of people as ‘less than’ and structures opportunities to advantage some and disadvantage others.”
So says an educational primer, “Ableism in Health Care” (PDF), part of the AMA Organizational Strategic Plan to Advance Health Equity: 2024–2025.
New perspective on impairment
The AMA primer was developed as part of the strategic plan’s effort to “push upstream” and address social determinants of health and underlying causes of inequities while advancing “disability justice in medicine.”
The primer notes that the advocacy of people with disabilities have shifted the conceptualization of disability away from a medical model that seeks to “fix” a person and has moved toward a “social model.”
This model describes how “societal restrictions and barriers are recognized and addressed as the causes of disability and exclusion,” the primer says. “In this view, a person’s activities are not limited by the impairment or condition itself, but by their environment, including institutional policies and systems.”
AMA member Joanna Bisgrove, MD, an assistant professor of family and preventive medicine with Rush University Medical Center in Chicago, explained that her hearing loss is an “impairment,” but it is not a disability unless she is unable to do her job. When she has the use of an amplified stethoscope, a scribe, and clear masks for her patients so she can read their lips, her hearing loss is not a disability.
Dr. Bisgrove spoke during an AMA Center for Health Equity open forum education session held as part of the 2024 AMA Annual Meeting in Chicago.
A member of the AMA Council on Science and Public Health, Dr. Bisgrove is also chair of the new AMA Disability Advisory Group.
She is serving with vice-chairs Alicia Wong, MD, MPH, assistant professor of family medicine at the University of Colorado-Anschutz School of Medicine, and Courtland Keteyian, MD, MBA, MPH, president and CEO of the Henry Ford Health clinically integrated network and medical director of occupational medicine at Henry Ford Jackson Hospital. Henry Ford Health is a member of the AMA Health System Program, which provides enterprise solutions to equip leadership, physicians and care teams with resources to help drive the future of medicine.
The advisory group stems from policy adopted by the AMA House of Delegates and it is tasked with developing and promoting tools to support efforts by physicians and medical students with disabilities “to advocate for themselves in their own workplaces.”
“I was born an advocate,” said Nancy L. Mueller, MD, a neurologist and pain-management specialist in private practice in New Jersey, an associate professor of neurology at New York University Langone, Grossman School of Medicine and secretary of the AMA Organized Medical Staff Section.
“I’ve been wearing a hearing aid for as long as I can remember,” Dr. Mueller said. “People ask: ‘Do you have a disability?’ I don’t feel like I do.”
Not all disabilities or impairments are noticeable.
“Invisible disabilities are all around us,” said Druv Bhagavan, an MD-PhD student at the Washington University in St. Louis School of Medicine serving as an alternate delegate for the AMA Medical Student Section.
“I have ADHD and multiple comorbidities—this is the first time I’ve disclosed that publicly,” Bhagavan said. "Invisible disabilities are also frequently invisible to the people who have them, leading to delays in recognition, diagnosis, treatment, and accommodation.
“It's critical to minimize barriers that impede patients, physicians, and trainees from seeking care," he added.
AMA pushes for inclusion
The AMA has detailed policy on medical care for people with disabilities, last updated in 2022.
It also has very specific policies such as supporting health insurance coverage for wheelchair repairs and opposing caps on Medicare outpatient rehabilitation therapy.
AMA Trustee Scott Ferguson, MD, spoke at the session and credited Dr. Bisgrove and other leaders for bringing a focus on ableism to the organization.
“This is something we have needed for a long time,” Dr. Ferguson said, adding that this includes selecting disability-friendly hotels to host AMA events.
“None are perfect,” he said. “But they are trying, and we are pushing them.”
Listen to Dr. Bisgrove tell her story in an episode of the “Stories of Care” podcast series presented by the AMA and CDC Project Firstline initiative.
Explore the AMA Ed Hub™ Health Equity Education Center and learn about AMA CME accreditation.
