Equity - it's a matter of attitude

A diverse workforce benefits any industry. A search will quickly reveal research highlighting increased profits, heightened innovation, and lower absenteeism. So, what's stopping us?

Attitudes.

Sometimes, we don’t even know that attitudes need changing. At a 2021 medical conference, a participant put forward this question - How do we generate new ideas for the medical profession? In a profession that is evolving its identity of diversity, the answer is closer than we think.

In my journey from medical school to working in the emergency department as a doctor, attitudes have both made my journey possible and challenging.

The emergency department that I work in is one of the busiest in Australia. It's a dynamic workplace. A front line of medicine. In this environment, the team welcomed me as a medical student all the way through to being a doctor. For their approach, the department was awarded a diversity award from the Australasian College for Emergency Medicine in 2020. I was similarly supported by the obstetrics and gynaecology department with success as a junior doctor. Both of these are physically active specialties.

The senior physicians in the emergency department have helped me expand my physical abilities. I’ve done everything from suturing wounds to learning how to intubate with video-assisted technology. Some have been just for academic interest in simulation environments. Intubation, for example, is a serious procedure where a failure can quickly kill the patient. For some of these modified procedures, it was probably the first time they’ve ever been attempted in the world.

To date, I have seen thousands of patients. Not one of them have questioned my capability, at least to my face, even once. To my knowledge, our customers have been happy. The senior doctors, or my managers, have always had an enabling approach.

However, one of the least physical specialties in the hospital once flipped that script. A majority of their doctors work from a desk. Still, a director of that department told me, “You’re not wanted in this department. I can't see how you can work here with a spinal cord injury. If anyone asks, you can’t tell them that I told you this. You have to tell them that the entire department doesn't want you.”

What’s the main difference between the stories? Attitudes.

Article 27 of the Convention on the Rights of Persons with Disabilities prohibits

"discrimination on the basis of disability with regard to all matters concerning all forms of employment, including conditions of recruitment, hiring and employment, continuance of employment, career advancement and safe and healthy working conditions”.

The treaties have trickled down into federal and state laws in many countries. The laws have trickled down into organisational policies and guidelines.

Sadly, the legal frameworks don't matter if attitudes don't change. I'm not sure why these attitudes exist. Perhaps it's fear. Perhaps it's engrained prejudice. If 10 years ago, someone told me that there might be a doctor with quadriplegia working in an emergency department, maybe I would’ve raised my eyebrow too.

If an emergency department – where life and death is on the balance - can enable a doctor with quadriplegia to work, then a majority of workplaces should have no trouble being inclusive to a diverse range of staff. However, the road to employment is often contingent on education.

I grew up in Sri Lanka. We moved around a lot. A period of that time was spent in a small village. In that village, I was the only kid with new shoes. Some of the other kids used to carry me over the water puddles, because they were terrified that my shoes would get dirty. They lived in small homes built with clay. There was no electricity. They studied into the night by the candlelight. Why? For these kids, education was the only way out of poverty. It was the only way to ensure a better future for their families.

I too am lucky to be here today because of the education that I've had. Without that education, I wonder if I would be writing these words to you. The chances are, I wouldn't be.

I often receive emails from students with disabilities struggling through education. Educators are not always inclusive. I once received a message from an allied health student using a wheelchair. The student had high distinctions across the board. Their educator insisted that they stand up for an assessment, even though it wasn't clinically necessary. Even if the patient's height was important, the beds in most hospitals are height-adjustable. Nonetheless, this became a point of contention which was eventually resolved. Stories like this are common.

Education empowers people. It too is a right in our treaties and laws.

Let's for a second put aside the human aspects of inclusion. Let's even put aside the innovation, profit, and productivity benefits. What would we rather? A tax-paying educated productive member of the community or a person relegated to social welfare? Even from a purely fiscal perspective, inclusion makes sense.

A politician once told me that, “In society, effort should be rewarded. But, we have a duty to make an equitable platform for everyone to make that effort. At the same time, we also have a duty to protect the rights and lives of the most vulnerable people in our society.”

I think she's got the right attitude.

Dinesh was the first quadriplegic medical intern in Queensland and the second person to graduate medical school with quadriplegia in Australia. Dinesh is a doctor, lawyer, disability advocate, and researcher. Halfway through medical school, he was involved in a motor vehicle accident that caused a cervical spinal cord injury. As a result of his injury and experiences, Dinesh has been an advocate for inclusivity. He is a founding member of Doctors with Disabilities Australia. Dinesh works in the emergency department at the Gold Coast University Hospital and is a senior lecturer at Griffith University. He was awarded the Medal of the Order of Australia in 2019 and was the Queensland Australian of the Year for 2021.

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