COMBATING ABLEISM: DR. LISA MEEKS HIGHLIGHTS CHALLENGES FACED BY PEOPLE WITH DISABILITIES AND SOLUTIONS FOR INCLUSION | A CONVERSATION WITH DR. LISA M. MEEKS

DR. LISA MEEKS is an Associate Professor of Learning Health Sciences and Family Medicine at the University of Michigan Medical School, co-creator of the social media campaign #DocsWithDisabilities, co-host of the Docs With Disabilities Podcast, and executive director of the DocsWithDisabilities Initiative. She is widely considered the leading expert on disability inclusion in health professions education and her work has been published in leading medical journals, including the NEJM, Lancet, JAMA, and Academic Medicine. Her work has also been featured on NPR in the Washington Post, CNBC News, Bloomberg Law, and TIME magazine. Dr. Meeks regularly collaborates with health professions associations and faculty across multiple health professions education programs. She is the lead author of the AAMC Special Report: Accessibility, Inclusion, and Action in Medical Education: Lived Experiences of Learners and Physicians with Disabilities co-developer of the AAMC Disability Webinar Series and currently serves as Disability Lead for the ACGME Equity Matters Initiative and an advisor to the ACGME committee on DEI. Her most valued contribution to academic medicine is mentoring the next wave of the healthcare workforce and creating space for DocsWithDisabilities to thrive.

Hello, Dr. Lisa Meeks. We are thrilled to have you join us. Do tell us a little about yourself?

I am an Associate Professor of Learning Health Sciences and Family Medicine at the University of Michigan Medical School and Executive Director of the DocsWithDisabilities Initiative. I’m dedicated to creating equal access in health professions education and to increasing representation of disabled physicians and healthcare workers to diversify and inform medicine.

As a researcher and a person with an expertise in disabilities, what’s your perspective on some of the modern challenges faced by people with disabilities around the globe and how best do you think these challenges can be addressed irrespective of the socioeconomic disparity between developed and developing nations?  

The challenges are lack of understanding, assumptions and stereotypes that drive policy and practice around inclusion—so essentially ableism. The solutions that are most scalable and impactful include the sharing of stories and successes of people with disabilities practicing in medical professions, these are the most direct mechanisms for combatting stereotype and assumptions.

From a policy and humanitarian standpoint, do you believe there is greater inclusion and opportunities for people with disabilities right now in comparison to a decade ago?

Absolutely. I think that in the last 5 years we’ve witnessed tremendous growth in the acceptance and in some respects the celebration of disabled people as healthcare providers. In addition to stories, we also have an incredible amount of resources.

How can the medical community, and specifically researcher like yourself, provide better support and accommodate the needs of disabled patients?

Individual providers can educate themselves about Ableism and the impact of ableism on their clinical decision making. Researchers of note include Tara Lagu and Lisa Iezzoni—every healthcare provider should be aware of their work. To understand how to accommodate a patient, I would say provide accessible materials, accessible exam tables and scales, and always have sign language interpreters available as needed—but mostly just ask them. Provide a mechanism in the appointment system or HER for patients to tell you what they need.

What do you think needs to be done moving forward to continue improvising the situation for people with disabilities?

A researcher/colleague of mine Dr. Neera Jain talks about the need for simultaneous harm reduction and education. We have to figure out a way to provide access in the more transactional/systemized way as a stop gap until we can educate a cohort of physicians who will arrive to practice with a foundation of disability humility, a level of disability consciousness, and a respect for the autonomy and ability of disabled people. This will take a while since at the current time we do not have any systematic disability education practices in the US medical education system.

You are the Founder of the Docs With Disabilities Initiative that works to enhance people with disabilities. Can you tell us more about the foundation/organization, and what specific actions you have taken to promote disability inclusion and empowerment?

The Docs with Disabilities initiative uses research, education, and sharing of stories to drive change in perceptions, disability policy, and procedures in healthcare education. Our aim is to build more inclusive educational environments for trainees with disabilities and increase representation of disabled providers in the healthcare workforce. To that goal we have published 68 podcast episodes interviewing doctors, nurses and other healthcare professionals with disabilities, we publish extensively on the topic and in the last two years have 24 manuscripts dedicated to this work. We empower programs and disabled learners through our resources and groups like Access In Medicine and Disability In Graduate Medical Education, which are working groups dedicated to creating resources in medical school and residency training. We also just launched a mentoring program specific to women in medicine with disabilities. Finally, our program works extensively with health professions associations to provide specialty specific resources to their constituents.

Can you tell us about any specific success stories or accomplishments that the foundation/organization has achieved, and can you tell us about any specific fundraising campaigns that have been particularly successful or impactful?

We don’t run fundraising campaigns.

What I love the most about the initiative is how it changes the minds of people who never thought they could enter a health professions degree program, but then after listening to the podcast decide to move forward. I am also so proud of how the initiative fosters and supports the next generation of disabled trainees and researchers through our funding for their research and presentations worldwide.

What are your plans for the future of Docs With Disabilities Initiative, and how do you see the foundation/organization continuing to make a positive impact on disability issues?

We’ve implemented multiple programs and research agenda’s but what we are the most excited for is a new connection to community college students, working to connect them to resources, advisors, mentors, and support their application to medical and nursing schools! We must start early in the process, especially for students less likely to consider health professions education. We are also committed to fully exploring and addressing the barriers at the intersection of race/ethnicity and disability.

2020 was a tough one for everyone due to the COVID-19 pandemic. Do you reckon the whole experience affected people with disability a lot more than it should have?

Most definitely although I want to be clear—everyone suffered during this time. My big concerns about the impact of COVID-19 are the healthcare workers who will develop long covid and be forced to leave their positions.

What advice would you give to someone who is newly disabled or who is caring for a disabled loved one?

Come to the work, the support or the identity from a strengths based model and reach out for supports—do not recreate the wheel. So many organizations are doing superior work in this space and are available for consult.

How can non-disabled individuals be better allies and advocate towards a more inclusive society that values and uplifts those within the disabled community?

Being a better ally and advocate involves understanding the experiences of disabled people, amplifying their voices, and actively working towards creating a more inclusive society. I would also encourage individuals to become an accomplice.

The terms “disability ally” and “disability accomplice” both refer to individuals who support and advocate for the rights and inclusion of disabled individuals. However, there are some nuanced differences between the two concepts:

A disability ally is someone who supports and operates in solidarity with disabled individuals. They actively work to challenge ableism, advocate for accessibility, and promote inclusivity. Allies educate themselves about disability issues, amplify disabled voices, and strive to create a more inclusive society. They often use their privilege and platforms to uplift the disabled community, but their involvement may be more passive or supportive in nature.

A disability accomplice takes allyship a step further. Accomplices recognize the systemic nature of ableism and actively work to dismantle those systems. They go beyond mere support and actively engage in direct actions and advocacy to challenge and disrupt ableist structures, policies, and practices. Accomplices prioritize the voices and leadership of disabled individuals, and they are willing to take risks and make personal sacrifices to promote disability justice and liberation.

Accomplices engage in solidarity and coalition-building efforts, center disabled individuals in decision-making processes, and collaborate with disabled-led organizations and movements. They aim to create lasting systemic change by challenging power dynamics and working towards a more equitable and inclusive society.

Everyone in this space can help us eradicate barriers by:

  1. Educating Yourself: Take the initiative to learn about different disabilities, their challenges, and the experiences of individuals living with disabilities. Read books, articles, and online resources, watch documentaries, and listen to podcasts that provide insights into the disabled community.
  2. Listen and Learn from Disabled Individuals: Engage in open and respectful conversations with disabled individuals to gain a deeper understanding of their needs, experiences, and perspectives. Respect their expertise and learn from their lived experiences.
  3. Amplify Voices: Use your platform, whether it’s social media, workplace, or community, to amplify the voices of disabled individuals. Share disabled stories, achievements, and advocacy initiatives. Give credit where it is due and ensure that disabled voices are included and recognized.
  4. Advocate for Accessibility: Advocate for accessibility in all spaces. Encourage the adoption of universal design principles, which aim to create products and environments usable by all people, regardless of their abilities.
  5. Challenge Ableism: Actively challenge ableist attitudes, assumptions, and stereotypes. Speak up when you witness discrimination or exclusion based on disability. Educate others about the harmful effects of ableism and promote a more inclusive mindset.
  6. Support Disability-Inclusive Policies: Support policies and initiatives that promote the rights and well-being of disabled individuals. Advocate for the implementation of inclusive policies in areas such as employment, healthcare, education, and accessibility.
  7. Engage in Intersectional Advocacy: Recognize that disability intersects with other forms of identity and marginalization, such as race, gender, sexuality, and socioeconomic status. Advocate for a more inclusive society that addresses the unique challenges faced by disabled individuals from diverse backgrounds.

Finally, are there any initiatives or international organizations that you recommend people support or that are helping to improve the lives of disabled individuals?

There are so many. In the space I work in, I recommend the following:

ORGANIZATIONS DEDICATED TO DISABILITY INCLUSION IN MEDICINE

Access In Medicine (AIM): A working group of disability resource professionals (DRPs), faculty, researchers, and providers addressing disability-related barriers in undergraduate medical education. AIM is a program of the Docs With Disabilities Initiative. 

Association on Higher Education And Disability (AHEAD): AHEAD is a leading professional membership association for individuals committed to equity for persons with disabilities in higher education. disseminates data, promotes research, and furthers evidence-based practice.

Association of Medical Professionals with Hearing Losses (AMPHL): Non-Profit organization serving Deaf and hard of hearing healthcare professionals.

Disabled Doctors Network (UK): Supports the welfare, rights, and inclusion of chronically ill and physically disabled doctors and medical students in the United Kingdom.

Docs With Disabilities Initiative (DWDI): The Docs With Disabilities Initiative uses research, education, and sharing of stories to drive change in perceptions, disability policy, and procedures in healthcare education. It aims to build more inclusive educational environments for trainees with disabilities and increase the representation of disabled providers in the healthcare workforce. DWDI includes the Docs With Disabilities Podcasts, Research Team, and Initiative Programs. 

Doctors with Disabilities Australia: Doctors with Disabilities Australia is a body advocating for an inclusive profession without regard to physical attributes.

Canadian Association of Physicians with Disabilities: A Canadian organization established to provide a national forum for discussing issues of mutual interest and concern to physicians with disabilities.

Coalition for Disability Access in Health Science Education (CDAHSE): Sometimes referred to as “The Coalition.” The Coalition is a professional organization dedicated to developing, advancing, and disseminating leading practices that facilitate access and opportunities for people with disabilities in health science education. 

Medical Students with Disabilities and Chronic Illnesses (MCDCI): MSDCI is a student-led organization striving to support and serve medical students with disability and/or chronic illnesses, committed to increasing the accessibility of medical education for trainees of all abilities and advocating for and improving health equity for patients with disabilities.

Society of Physicians with Disabilities: The Society of Healthcare Professionals with Disabilities provides resources and support for disabled physicians, physician assistants, and students. The mission of the Society is to foster a supportive community and to provide resources and tools for disabled healthcare professionals and students, their family members, and their friends.

Stanford Medicine Alliance for Disability Inclusion and Equity (SMADIE): SMADIE advocates for resources, education, training, policies, accessibility, and services at Stanford Medicine and beyond, not guided solely by law and an accommodations-based approach, but by dismantling systemic discrimination through universal design. SMADIE encourages synergy and collaboration within and beyond the Stanford community in service of Justice.

Student National Medical Association (SNMA): Student professional organization committed to supporting current and future underrepresented minority medical students, addressing the needs of underserved communities, and increasing the number of clinically excellent, culturally competent, and socially conscious physicians.

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