PAs with Disabilities

[zoologist]

Anybody here have a disability? I have an ileostomy + Crohn’s Disease - trying to determine how accepting the profession is to disabled PAs. Some areas of medicine are not keen on providers with disabilities - is it any different in the world of PAs? Many thanks!

[VeryOldPA]

There is this law called the American With Disabilities Act.  The law prevents any employer from refusing employment to someone with a disability as long as they are physically able to carry out the duties of the job. In addition employers are required to make “reasonable accommodations“ for anybody that has a disability. Employees are not allowed to ask you about your disability    I have seen several providers with all kinds of disabilities  including cerebral palsy, being wheelchair-bound, being an author extremity amputee so  I can’t see any reason why employer could get away with just using you employment strictly because you have Crohn’s disease in ileostomy. 

[Marinejiujitsu]

I just had a stroke from a vertebral artery dissection in jiu jitsu. My employer has been cool so far. I probably wouldn't even disclose it until you get hired unless it's something that can affect you doing the job requiring a lot of work arounds.

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[jmj11]

I never thought of myself as a PA with a disability, but suddenly I am. With my cancer and renal failure, requiring dialysis, it is a challenge to schedule my clinic time beyond 2 - 1/2 days a week. I must leave for 100 days (plus) for a stem cell transplant, starting next week. My job and clinic is being threatened (although I have a fill-in). I will not be surprised if I am out of a job when I return. Others have encouraged me to raise the question of the American with Disabilities Act and get a lawyer. I can't imagine going through that process or just remaining on long term disability until I retire. But I love seeing patients and never thought my career would end in this way.

[jmj11]

31 minutes ago, Marinejiujitsu said:

I just had a stroke from a vertebral artery dissection in jiu jitsu. My employer has been cool so far. I probably wouldn't even disclose it until you get hired unless it's something that can affect you doing the job requiring a lot of work arounds.

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That sucks! Just had a patient who broke her radius (right and she is right-handed) during a self-defense class and I felt sorry for her, can't imagine what  you've been through. Seen it after chiropractic manipulations but never after martial arts.

[Marinejiujitsu]

Yeah, I have a feeling we are gonna see it more we look for it. I've already met another 11 people in a jiu jitsu dissection group I started 3 months ago. I also met one in the same city I train in that happened 2 months after mine.

I think sometimes it presents with vertigo and something like 25% have a source of infection the week prior. Most ER guys think, this has to be BPPV but people can dissect with something as little as a forceful cough.

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[Marinejiujitsu]

Crazy thing is my headache and neck pain wasn't really that bad to even bring me to the hospital. I thought I strained my neck and had a sinus headache.

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[jmj11]

One patient had a related cerebellar infarct and had significant ataxia, forcing him to loose his company (a house painting company). Chiropractic manipulation was the cause.

[ohiovolffemtp]

For the OP: one of my classmates in PA school had a colonostomy due to his Crohn's.  He completed PA school and got his license.  He worked at one of my prior hospitals both in the ED and as a hospitalist.  He did exceptionally well.  He also married and has a wonderful wife and 2 wonderful kids.  So, unless you're planning on practicing wilderness medicine (i.e. not in any building), I believe that you should not encounter any barriers.

[thinkertdm]

7 hours ago, Marinejiujitsu said:

Yeah, I have a feeling we are gonna see it more we look for it. I've already met another 11 people in a jiu jitsu dissection group I started 3 months ago. I also met one in the same city I train in that happened 2 months after mine.

I think sometimes it presents with vertigo and something like 25% have a source of infection the week prior. Most ER guys think, this has to be BPPV but people can dissect with something as little as a forceful cough.

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Were your symptoms such that ten out of ten pcps would treat as labyrinthitis or something, and never even considered a dissection?  I bring this up because I went to my pcp with vague dyspnea, and he ordered a pft, too late to catch the massive PE that was developing.  We go through these "most likely" lists, which work "most of the time" but for the rest of the time, we let the algorithm take over without thinking outside the box.

not the point of the original post, so I'll toss in mine: I have type 1 dm, and my closest co-workers know this in case of emergencies. I felt it was easier to tell them up front rather to look at my necklace when I fell over.  

I don't consider it a disability however; it makes me a better clinician, because I can see from the patients perspective, and I can relate to what they are going through.  Frustrating to me when my personal pcp doesn't know diabetes from a hole in the ground.

[Marinejiujitsu]

Were your symptoms such that ten out of ten pcps would treat as labyrinthitis or something, and never even considered a dissection?  I bring this up because I went to my pcp with vague dyspnea, and he ordered a pft, too late to catch the massive PE that was developing.  We go through these "most likely" lists, which work "most of the time" but for the rest of the time, we let the algorithm take over without thinking outside the box.
not the point of the original post, so I'll toss in mine: I have type 1 dm, and my closest co-workers know this in case of emergencies. I felt it was easier to tell them up front rather to look at my necklace when I fell over.  
I don't consider it a disability however; it makes me a better clinician, because I can see from the patients perspective, and I can relate to what they are going through.  Frustrating to me when my personal pcp doesn't know diabetes from a hole in the ground.

Yeah, I totally agree with you that real medical issues make you a better clinician.

Regarding my symptoms I had a couple episodes of vomiting and I couldn't even sit up due to the dizziness (pcos probably would have been partially be concerned) Then my clot broke into 3 which the vertigo subsided then I just had this buzzing like dizziness with mild ataxia (that point I could see why people would think benign but in the context of a choke being applied or neck torquing it wouldn't make sense. That's why I went back to the hospital, and I was getting super bad headaches and neck pain.

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[LKPAC]

15 hours ago, zoologist said:

Anybody here have a disability? I have an ileostomy + Crohn’s Disease - trying to determine how accepting the profession is to disabled PAs. Some areas of medicine are not keen on providers with disabilities - is it any different in the world of PAs? Many thanks!

Excuse my ignorance.  My first thought is that I don't see how this condition makes you any less valuable than a PA without Crohn's and ileostomy.  In what way would this effect your work?  Does your employer even need to know?

Edited April 23, 2019 by LKPAC

[Reality Check 2]

I don't consider Crohn's and an ileostomy a disability. You have patina in my opinion. 

We all have something. I have 2 autoimmune diseases, a hx of migraines and I am fluffy. Makes me human. Doesn't affect my ability to work - migraines decreased with each decade after 35 and (knock wood) haven't had one in almost 3 yrs now. 

Our humanity contributes to our empathy and willingness to investigate, diagnose and treat. I can relate to my patients. 

Very sorry to hear about the renal failure, dialysis and dissections though - those will reduce professional TIME but I don't think it makes you a lesser provider. 

That said - if the ADA exists for these issues in other industries - they exist for us.  

We have to do what it takes to preserve our own health and sanity - if it gets even one of us protection while we heal or adapt - then so be it. Not a weakness - a tool. 

I don't have FMLA for any of my conditions as they don't really interfere with my work - not a reason I have to call out sick. If one does have a condition that would require intermittent appts, therapy, dialysis, treatment or possible flares that would cause time away from work - then fill out the FMLA form just like you do for others.  Only HR and perhaps a direct superior need to know. 

I have met more PAs over the years who are honest about their medical conditions and how it is an asset to their abilities. We are seasoned and most of us have worked as something else prior to PA - we tend to come with more life experience than a career student track. I firmly believe it makes us better providers.

Take care of yourself, ask for help when needed - back each other up.

Take care everyone!!

[Cideous]

Uggh and here I go again.  I promise you all, I am not really this salty in real life, but.........

 

Don't mention it.

 

1.  It's none of their damn business.  Period.

2. ADA or no ADA there is 100% inherent bias for providers deemed disabled, broken, hindered or anything else that might make you less robotic in a practice.  In the eyes of the employer, we are there to make money.  Period.  Full stop.  Any weakness be it physical, mental or psychological will be seen as...well, weakness.  Your odds of getting hired will plummet.  I've seen it time and time again happen.  Think about this for a minute.  It is often hard for providers who have the audacity to get sick or injured while employed.  They are frequently screwed schedule wise or just pushed out the door.  By letting a prospective employer know ahead of time about any inherent weakness is just inviting bias before you even begin.

In a perfect world we should be allowed to be human.  That world does not exist or at the very least is incredibly rare.

Report any weakness at your own peril.

Cynical?  Yup.  Correct.  You betcha.   I hate it, but it is what it is....

 

[sas5814]

I hate when reality intrudes on ideal. My wife recently had to get hearing aids. Her work started a big push about vital signs (she works in psych) so she told them she would need a special stethoscope so she could take vitals while wearing hearing aids. No more conversations about getting everyone stethoscopes...and that day position you were next in line for? We think you are better suited to the night shift.

I'm ready to lawyer up. She is afraid of getting fired which would just bolster the claim.

Life... what are you gonna do?

[Kaepora]

I have severe UC and I would never list that as a disability.  I do get IV infusions every couple weeks and I have to take off that day.  I am rapidly approaching a colectomy and trying to get my affairs in order for that.  But my group has been more than understanding.  As long as you are good at your job and don't make excuses when you are there, most reasonable people won't mind if you need a couple minor considerations. 

[rev ronin]

On 4/22/2019 at 9:34 PM, Marinejiujitsu said:

Crazy thing is my headache and neck pain wasn't really that bad to even bring me to the hospital. I thought I strained my neck and had a sinus headache.
 

We just had a deputy locally who had a similar event after self-manipulation of his neck.  Scary stuff!

[Joelseff]

I have significant hearing loss and wear hearing aids. My previous employer made a contract that I had to use an electronic/amplified stethoscope at work. I thought that was reasonable but they wouldn't reimburse me for it. It was just for formality I think so they can cover their butts if I miss something on exam. Who knows?

I also am a disabled vet with multiple MSK issues. This I have not disclosed to any employers. They see me limping everyday though lol.

My hearing loss is due to an Autoimmune inner ear issue so I get flare ups every so often of my vertigo (severe) I have an FMLA in place from my physician for this though so it can cover my butt when I have flare ups. Sad thing is Kaiser only covers it for 6 mos and I would have to Re apply q 6 mos. And Kaiser's paperwork system is like the DMV.

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[AJRCS]

I’m wondering about this too. My neuropathy is progress faster than I thought. I may eventually need a cane or wheelchair. I’m not sure being a Surgical or Ortho/Sports Med PA is an option anymore.

[LBDwisconsin]

Looking for PA/NP and MD/DO with disabilities for a mentor. I am a PA and have had a h*ll of a time finding tolerant stable employment due to combinations of disabilities with medical accommodations, race/color, gender (women against women specifically), protected veteran, & I'm older. Laws against discrimination don't mean crap to employers, except don't get caught and if you do, fight it regardless of proof. I'm really thinking of switching careers again because of the blatant hostility in the market. Where can I go from here? Anyone been thru the ringer and made it work, or finally left bec of it? What did you do or what did you move into?  

[sas5814]

I am not in quite that position, but I do have some issues that require nominal accommodation. Without getting into details, it's a little hard to give great advice but I currently work for the VA and they are all about reasonable accommodation. The hiring process is a bit like having your toenails slowly extracted with pliers, but they understand the issues particularly as a protected veteran. The last 2 docs we hired in my clinic are women in their 70's so age clearly isn't an issue here. It would just be a matter of finding an open position to apply for that you can do with reasonable accommodation.

Good luck

[ventana]

start your own business

[AbeTheBabe]

What are your symptoms like? If you have an ileostomy that means you're not rushing to the bathroom every couple of hours.

I have Crohn's and I never list that in any application as luckily I've been relatively asymptomatic for the past decade. I have been on biologic infusions for years. I've been an ortho PA for 7 years and I've never had to scrub out of the OR or take a bathroom break in the middle of clinic, so I don't list as a disability and risk a prejudice. Now that I'm working though and if things take a turn for the worse then I have no issue going to HR and letting them know to get accommodations. People at work know I have Crohn's anyway, but luckily it doesn't affect anything.