How being a patient helped turn an Ottawa physician into an advocate for doctors with disabilities

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Dr. Michael Quon was on a cycling tour with friends in 2015, celebrating the end of medical training, when his life changed in a flash.

He has no memory of the bike crash that left him with a traumatic brain injury, intubated and in a coma when he arrived at hospital. It took weeks before he could begin to piece together what had happened and why he was in there.

His recovery was lengthy and at times discouraging, but Quon says the experience has made him a better doctor. Now the general internal medicine specialist at The Ottawa Hospital is working to improve the system to better support doctors who are living and working with disabilities. That work has received notice across Canada and the United States.

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After the crash, Quon was in shock and trying to figure out what it would mean for his future as a doctor.

“I was just finishing training and then I became a patient.”

Quon was originally hospitalized in Colorado, where he crashed. Once stabilized, he was transferred to the acquired brain injury rehab program at The Ottawa Hospital (TOH), where his road to recovery would begin.

He was determined to “be the best patient and listen to everything that was advised of me and just try to keep building on what I was struggling with.”

He remained in hospital for two months of intense rehabilitation and continued outpatient rehab for nearly a year after returning to Montreal, where he had finished his medical training. During his recovery, he worked with psychologists, occupational therapists and speech language therapists, and returned to work.

But he struggled with situations that provided “excessive sensory input.” Too much noise or light, or with multiple conversations, would exhaust him and worsen other symptoms, including slowing his thought processes and making it difficult to sustain his attention. That would be a challenge requiring accommodation as he began his internal medicine career.

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But the experience has also given him insight into patient needs, making him a better doctor, he says.

“I don’t think I appreciated enough the patient perspective in my own medical training. Having that vulnerability and disability and uncertain future, and all that experience as a patient offered me a lot of insight into the struggles and challenges people face,” he said.

Crucially, Quon said, he learned how important it was to feel cared for and understood by health-care providers.

“Feeling that they understood me, understood what I was struggling with and offered empathy, was so critical to me as a patient. It was a bit of a lightbulb moment because I hadn’t fully appreciated that before.”

His own experience becoming a patient and the process of recovery have driven Quon to become an outspoken advocate in support of accommodation for physicians with disabilities.

It is an area that needs attention urgently, he says. Quon calls for stronger leadership in Canada to address needs of doctors with disabilities.

In 2022, Quon worked with other members of The Ottawa Hospital’s department of medicine to develop a policy that would accommodate physicians in the department living with disabilities. The pioneering policy was the first of its kind in Canada and has drawn attention from across the country.

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“It was the first policy of its kind at any academic hospital in the country. It highlights that physicians with disabilities are valued and offer unique insights,” he said.

Other hospitals as well as physician organizations have expressed interest in the policy, which focuses on providing reasonable accommodation to physicians with disabilities and reducing barriers, he said.

“It has gotten quite a lot of interest because it is the first. I am quite proud of it,” he said.

Still, he said Canada is far behind peer countries when it comes to accommodations and support for doctors with disabilities, something that is crucial during a period of physician shortages. Accommodation allows physicians to continue working and contributing.

There are thousands of physicians across Canada with disabilities, including those who have developed disabilities during their careers.

“If they are accommodated, they can do meaningful clinical work and take care of patients. If not, it can lead to early retirement and attrition from the workforce,” Quon said.

He said somewhere between three and 10 per cent of Canada’s 100,000 physicians are living with disabilities, and many, like him, are looking for leadership on the issue from medical associations.

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Countries such as the U.S., United Kingdom and Australia are developing initiatives, programs and awareness campaigns around physicians with disabilities, he said.

Physician well-being and preventing burnout has become a focus of the Canadian Medical Association and other organizations, he said, but accommodation and inclusion of physicians with disabilities have not been priorities, which is harming physicians.

Quon said many physicians with disabilities had faced discrimination and worsened mental-health outcomes because of a lack of accommodation and inclusion. Some just left the workforce.

“Aside from being the right thing to do, it creates a more inclusive environment that can improve retention of physicians with disabilities. This is critical in this day and age,” he said.

Recently, Quon wrote a piece that was published in the prestigious journal JAMA. In it, he critiqued the new U.S. national plan for health workforce well-being, which is aimed at reducing burnout. He said he was concerned the plan did not address the needs of health-care workers with disabilities and reflected a culture of ableism.

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“Ableism is entrenched in the culture of medicine and represents a bias against and devaluation of physicians with disabilities,” he wrote.

“The structural ableism and inequities faced by physicians with disabilities not surprisingly have a profound impact on their wellbeing. Physicians with disabilities are more likely to have worse mental health outcomes compared with those without disabilities. In residents across multiple specialties, an association between a lack of accessibility and increased risk of depression was identified.”

There is a national plan for health workforce well-being in the works in Canada. Quon hopes the Canadian plan is more inclusive when it comes to physicians with disabilities.

“I am hoping we can learn from what the Americans have done and do a better job.”

Quon said there was an urgent need for doctors’ associations and others to work on improving inclusion for doctors with disabilities: for the health system, for doctors and for patients.

“It is well known that a physician population that better reflects the patients it serves is better for patient care and can improve the quality of care,” Quon said.

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