Updated: Apr 27
The Royal College of Surgeons of England's recent report on diversity and inclusion highlights the difficulties of marginalised groups working as surgeons in the UK. People with disabilities are mentioned in the report, although their tendency to be excluded in healthcare is not something new (see also the King's Fund report from 2015 on the same subject for the whole of the British National Health Service). A recent article by Miranda Schreiber captures the lived experience of a disabled doctor: 'If I said the word 'pain' [colleagues] took it as coded language for 'I'm lazy' and 'I can't do my work''; as does this TED talk by Hannah Barham-Brown: 'even some of my colleagues have been less than welcoming when I roll in...'. It should not be contentious that people with disabilities face significant barriers if they try to thrive in the medical business - ironically perhaps more so than in other businesses.
There are many reasons for this and a humble blog post can't get into them all. One link which has not yet been recognised anywhere else is how the cult of workism creates an environment where work-worship is viewed positively. If you don't fit in, or you can't, then you're not one of the club and you're excluded.
What does toxic workism look like on the ground? It's staying at work after a night shift, coming in on days off and signalling this extra work, pushing unreasonable work demands on colleagues, undermining colleagues who refuse to bend to those demands, working beyond rota hours (and making a virtue of this) and many other work-seeking and signalling behaviours.
This is not exclusive to medicine, or to the UK. For example, it has been explored in an influential essay by Derek Thompson ('The Religion of Workism is Making Americans Miserable').
Calls are now being made to ditch this burnout-causing "hustle culture" in the wake of the COVID19 pandemic. If we want to really create workplaces which don't discriminate against people with disabilities, there is a need to reduce workism which favours the endurance capacity of individuals. This means removing rewards and adding disincentives for over-working and work-hard-signalling. Most of us can't make any system/structural changes happen, but we can change the way we act, the advice we give and the pressures we transmit to those around us.