Q Is the hospital administration or the medical staff responsible for accommodating physicians with disabilities?
A Accommodating physicians with disabilities is a shared responsibility. How that responsibility is divided depends on each hospital. In some hospitals, disabled physicians may be able to coordinate accommodations directly with the CEO or chief operating officer, whereas in other organizations, they may discuss these issues with their department chair, who then brings the issues to administration. The hospital is responsible for paying for and implementing most accommodations, such as adjustable operating tables and designated handicapped parking spaces. The medical staff is responsible for providing support to the disabled physician. For example, if a physician's disability requires a change to the on-call rotation because he or she cannot practice at night, medical staff leaders are responsible for ironing out those details and communicating the changes to the rest of the medical staff.
Q Does the medical staff need to include language protecting disabled physicians in the bylaws?
A It's not necessary to include specific language to protect disabled physicians in the medical staff bylaws because the ADA covers all the bases, says Linda Ford, CPCS, CPMSM, director of medical staff services at Dameron Hospital in Stockton, CA. In addition, a hospital's HR policy often covers disability issues for employed physicians.
However, spelling out how your medical staff will respond to requests for accommodations and evaluate the performance of disabled physicians will guide collegial conversations down the road should a physician become disabled or if an already existing disability worsens, says Wilma Hunt-Watts, DPM, a disabled Long Island-based podiatrist.
Q Which medical staff leaders or committees should be involved in assisting physicians with disabilities?
A Every hospital should have a physician health committee whose job includes advocating for disabled physicians and keeping tabs on their performance to ensure that a physician's diagnosis is not worsening. Although physician health committees were originally designed to assist physicians with addictions outside of the disciplinary process, the scope of the committee can be expanded to include disabled physicians.
"A lot of physicians have a hard time knowing when to quit. Ideally, that is where your physician health committee helps you make that decision," says Dean White, DDS, MS, a medical staff consultant in Granbury, TX. "We had to do that with an orthopedist. It became obvious to us, and finally to him, that he had to quit, but it took all of us to get there with him."
Whether your organization has a formal committee or manages disabled physicians on a case-by-case basis, it's important to have support available to disabled physicians. Nancy O'Brien, MD, a disabled physician who formerly practiced in Ottumwa, IA, suggests that medical staff members with disabilities develop a relationship with their medical staff president. "You are talking to another physician, and then you have someone who is going to be looking out for you," O'Brien says.