Medicine & The Neurodiverse: Beyond ‘The Good Doctor’

Beyond ‘The Good Doctor’: Exploring Medical Career Opportunities for the Neurodiverse

Diversity has long been a topic of discussion amongst human resources experts and hiring managers. Usually, diversity means having employees from a wide range of backgrounds, including gender, race, ethnicity, sexual orientation, and socioeconomic status. But recently, a new type of diversity has been added to the mix: neurodiversity, which broadly refers to including individuals with a wide range of neurological conditions (more on defining neurodiversity below).

The television show “The Good Doctor” has refocused attention on neurodiverse medical careers since the release of the American version of the show in fall 2012. The show’s main character, Shaun Murphy (played by Freddie Highmore), has both autism spectrum disorder and savant syndrome, which help make him an extremely talented surgical resident. But like all television shows, “The Good Doctor” portrays a fictional story rather than reality. So what do medical careers actually look like for the neurodiverse, and are such conditions covered under the Americans with Disabilities Act (ADA)?

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Defining Neurodiversity

Australian sociologist Judy Singer coined the term neurodiversity while she was writing her dissertation from 1996 to 1998, and she actually published the dissertation in 1999 under the title Disability Discourse. Singer’s research mostly focused on autism spectrum disorder, as both her mother and her daughter had Asperger’s Syndrome, a “high-functioning” form of autism. Originally, neurodiversity was used to refer to people on the autism spectrum (as opposed to individuals who are not on the spectrum, and therefore considered “neurotypical”).

“For me, the key significance of the Autism Spectrum lies in its call for and anticipation of a politics of neurological diversity, or ‘neurodiversity,’” Singer wrote in her dissertation. “The neurologically different represent a new addition to the familiar political categories of class/gender/race and will augment the insights of the social model of disability.”

However, the definition of neurodiversity has expanded over the past 20 years. Many people now use “neurodiversity” to refer to differences beyond autism spectrum disorder, including dyspraxia, dyslexia, attention deficit hyperactivity disorder (ADHD), and Tourette Syndrome. Some also incorporate mental illnesses under the neurodiversity umbrella, including depression, anxiety, and obsessive compulsive disorder (OCD). Others may extend the definition further still, to neurological disorders such as epilepsy. While the term is becoming more and more popular, there is no official definition or criteria for neurodiversity from a clinical standpoint.

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Medical Careers for the Neurodiverse

Just as neurotypical individuals find themselves in a variety of careers, so do neurodiverse people. No one career (medical or otherwise) is a good fit for all neurodiverse individuals, and even people with the same neurological condition — such as autism spectrum disorder — may have wildly different capabilities and preferences. Fortunately, there are a variety of medical careers available that fit a wide range of capabilities, from medical assistants, health information technicians, and medical transcriptionists to dentists, nurse practitioners, and surgeons.

While some neurodiverse individuals do need special accommodations in the workplace, they may also bring great talents, like the ability to concentrate for long periods of time or to spot patterns in clinical data that others cannot. Major multinational companies — such as SAP, Hewlett Packard Enterprise, Microsoft, and EY — already have hiring processes in place to identify and hire neurodiverse talent because of these skills. Some medical professionals even argue that having certain neurodiverse conditions such as depression make them a better, more empathetic caregiver.

However, pursuing a medical career as a neurodiverse individual does require careful thought, especially when it comes to accommodations one might need in a workplace. For example, if an individual shows limited or inappropriate social interactions or difficulty with nonverbal communication (common symptoms of Asperger’s Syndrome) then a people-oriented medical position such as a doctor, nurse, or therapist is probably not the best fit. That individual might want to look into becoming a medical researcher, lab tech, or finding another medical position that doesn’t require a constant barrage of social interactions and interruptions.

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Accommodations for the Neurodiverse

Choosing whether or not to disclose a neurodiverse condition in the medical workplace is as personal of a decision as choosing a medical career. The legal situation can also be a bit nebulous, because the Americans with Disabilities Act deliberately does not name specific conditions that are covered by the act.

As for what the ADA does cover, title I requires employers with 15 or more employees to “provide qualified individuals with disabilities an equal opportunity to benefit from the full range of employment-related opportunities available to others.” The employers cannot discriminate against job applicants or employees with disabilities, and must provide “reasonable accommodation to the known physical or mental limitations.” In 2016, an amendment to the ADA did substantially expand the definition of a disability, which now means an impairment that “substantially limits the ability of an individual to perform a major life activity as compared to most people in the general population.”

But the “substantially limits” standard can be tricky to interpret in the case of certain neurodiverse conditions. For example, clinical depression can be considered a disability under the ADA, but not everyone who has depression is covered under the act. The severity of the depression plays a role in whether or not it “substantially limits” the person’s ability to “perform a major life activity,” and therefore whether or not the depression counts as a disability.

Medicine Should Welcome Neurodiversity

Medicine and healthcare can be difficult fields to work in, and living with a neurodiverse condition comes with its own set of challenges as well. However, neurodiverse individuals should not automatically dismiss the idea of working in the medical field, as there are a wide variety of medical careers that are suited to a wide variety of people. Furthermore, if your neurodiversity counts as a disability under the ADA, your workplace may even be able to make accommodations for you so you can continue successfully in your medical career.

If you think you have been discriminated against in your medical career because of a neurodiverse condition, an employment law attorney can help you figure out whether or not you’re covered by the ADA, and are justified in requesting reasonable accommodations.

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