June 1, 2018 Historically and across societies people with disabilities have been stigmatized and excluded from social opportunities on a variety of culturally specific grounds. These justifications include assertions that people with disabilities are biologically defective, less than capable, costly, suffering, or fundamentally inappropriate for social inclusion. Rethinking the idea of disability so as to detach being disabled from inescapable disadvantage has been considered a key to twenty-first century reconstruction of how disablement is best understood. Such ‘destigmatizing’ has prompted hot contestation about disability. Bioethicists in the ‘destigmatizing’ camp have lined up to present non-normative accounts, ranging from modest to audacious, that characterize disablement as “mere difference” or in other neutral terms. The arguments for their approach range from applications of standards for epistemic justice to insights provided by evolutionary biology. Conversely, other bioethicists vehemently reject such non-normative or “mere difference” accounts, arguing instead for a “bad difference” stance. “Bad difference” proponents contend that our strongest intuitions make us weigh disability negatively. Furthermore, they warn, destigmatizing disability could be dangerous because social support for medical programs that prevent or cure disability is predicated on disability’s being a condition that it is rational to avoid. Construing disability as normatively neutral thus could undermine the premises for resource support, access priorities, and cultural mores on which the practice of medicine depends. The “mere difference” vs. “bad difference” debate can have serious implications for legal and policy treatment of disability, and shape strategies for allocating and accessing health care. For example, the framing of disability impacts the implementation of the Americans with Disabilities Act, Section 1557 of the Affordable Care Act, and other legal tools designed to address discrimination. The characterization of disability also has health care allocation and accessibility ramifications, such as the treatment of preexisting condition preclusions in health insurance. The aim of this conference was to construct a twenty-first century conception of disablement that resolves the tension about whether being disabled is merely neutral or must be bad, examines and articulates the clinical, philosophical, and practical implications of that determination, and attempts to integrate these conclusions into medical and legal practices. Learn more: http://petrieflom.law.harvard.edu/events/details/2018-petrie-flom-center-annual-conference

1. MEDICAL PROFESSIONALS WITH DISABILITIES
WORKFORCE AND ASSOCIATED CHALLENGES
Paulchris Okpala, D.HSc, MHA, MPA, RCP, CRT
Department of Health Science and Human Ecology
California State University, San Bernardino
pokpala@csusb.edu
1

2. Introduction
2
• Despite the provisions of American with Disabilities Act and Amendment
Act (ADAAA) of 2008, the US employment environments do not favor
the individuals with disabilities (Eckmeier et al., 2012)
Percentage of the total population

3. Introduction
3
 What is the situation in the healthcare sector?
Concerns about
medical
professional with
disabilities
(Neal‐Boylan,
2012)
High frequency of quit or show
the intention to quit employment
Low employment rates
Challenges in the medical
education
 Do the above concerns suggest possible presence of employment
challenges faced by medical professionals with disabilities?

4. Study Aim
4
Assess the current trends in the integration of medical professionals
with disabilities into employment and education, and the role played by
organizational culture and leadership in addressing the barriers to entry
into the medical profession and education
1. What is the trend in the employment and education of the
medical professionals with disabilities?
2. What are the existing barriers to the entry of medical
professionals with disabilities into the medical profession and
education?
3. How do healthcare leadership approach influence the barriers to
employment among medical professionals with disabilities?
Research Questions

5. Methodology
5
Final sample: 47 studies
Include studies: 67
Selected databases
Health Management Database, NCBI, EBSCO, National
Library of Medicine database , Google scholar
Analysis
Data open and line-by line coded and analyzed
using descriptive and Kruskal–Wallis H test
Retrieved studies: 116
Design: Quantitative analysis of existing studies
Database Selection
based on relevance,
and quality
Studies retrieval: Boolean
strategy using selected search
terms
Selection based on date of publishing
(2013-2018)
Selection by screening the abstract

6. Results
6
The trend in the employment and education of the medical
professionals with disabilities
Year Education Employment
% S.E % S.E
2009-2010 8.85 1.099 12.3 3.008
2011-2012 8.91 2.003 12.9 2.006
2013-2014 8.71 1.1 13.8 3.177
2015-2016 9.18 0.967 14.4 2.94
Table 1: Trend in the employment and education of the medical
professionals with disabilities in the United States between 2009 and 2016
 The number of medical students with disabilities increased by 0.33 %
between the period 2009-2010 and 2015-2016
 The number of medical professionals with a disability also increased by
2.1% during the same period

7. Results
7
The existing barriers to the entry of medical professionals with
disabilities into the medical profession and education
Frequency of reporting P
% S.E
Education Technical standards 43.1 1.03 0.24
Accommodation 53.3 0.933 0.04
Employment
Lack of technical
support
38.5 2.94 0.01
Altered clinical
schedules
27.6 1.955 0.9
Non-supportive
organizational culture
61.4 2.511 0.05
Table 2: The barriers to the entry of medical professionals with disabilities into
the medical profession and education
 Barriers associated with accommodation significantly affect the education
of the individuals with disabilities (p=0.04).
 Barriers to employment include the lack of technical support (P=0.01), and
the non-supportive organizational culture (P=0.05).

8. Results
8
Key healthcare Leadership factors that influence the barriers to
employment
0
10
20
30
40
50
60
70
80
Representativeness Sensitivity Inclusivity
Frequency,%
Figure 1: The influence of healthcare leadership on barriers to employment
The Frequently reported factors include:
 Leadership Representativeness (53 %): Representation of the
individuals with disabilities in the leadership position
 Leadership inclusivity (65 %): Involvement of the individuals with
disabilities in policy formulation)
 Leadership sensitivity (41 %): How informed and responsive the
leadership is to the need of individuals with disabilities

9. Discussion
9
 The findings of this study reflects what have been observed by
previous researchers.
 The slight increase in the number of individuals with disabilities
who enter into medical profession is a trend that has been
reported by Brault, (2012) and Eckmeier et al. (2012).
 Marshak et al. (2010) have also observed the presence of
accommodation barriers in the medical learning institutions
 The reported barriers associated with the lack of technical
support and non-supportive organizational culture have also been
reported by Fevre et al. (2013).

10. Conclusion
10
 The number of individuals with disabilities who have entered into
the medical profession from 2009 to 2016 is low.
 Accommodation, the lack of technical support and non-supportive
organizational culture significantly affect the employment and
education of the medical professionals with disabilities
 A leadership approach that is characterized by leaders sensitivity,
leadership inclusivity, and leadership representativeness is key in
addressing the highlighted barriers.

11. References
11
Brault, M.W. (2012) Americans with disabilities [PDF document]. Retrieved
from United States Census BureauWeb site:
https://www.census.gov/newsroom/cspan/disability/20120726_cspan_disability
_slides.pdf
Eickmeyer, S. M., Do, K. D., Kirschner, K. L., & Curry R. H. (2012). North
American medical schools’ experience with and approaches to the needs of
students with physical and sensory disabilities.Academic Medicine 87(5), 567–
73.
Fevre, R., Robinson,A., Lewis, D., & Jones,T. (2013).The ill-treatment of
employees with disabilities in British workplaces. Work, employment and society,
27(2), 288-307.
Marshak, L.,VanWieren,T., Ferrell, D. R., Swiss, L., & Dugan, C. (2010). Exploring
barriers to college student use of disability services and accommodations.
Journal of Postsecondary Education and Disability, 22(3), 151-165.
Neal‐Boylan, L. (2012).An exploration and comparison of the worklife
experiences of registered nurses and physicians with permanent physical
and/or sensory disabilities. Rehabilitation Nursing, 37(1), 3-10.

12. Contact Information
Paulchris Okpala, D.HSc, MHA, MPA, RCP, CRT
Associate Professor
Director, Master of Science in Health Service Administration
Department of Health Science and Human Ecology
California State University
5500 University Pkwy, San Bernardino, CA 92407
Office: PS 219
Phone: 909-537-5341
Email: pokpala@csusb.edu
Chair, Academic Affairs
Healthcare Executives of Southern California
https://hce-socal.org/about-us 12