I do wanna jump in at this leg of the conversation because my wife is a doctor and I've been severely disabled since before she started medical school, and literally just knowing and caring about a disabled person has made her a way better doctor.
there are huge issues in the education process, the way it deliberately excludes the disabled both from joining the field and from being presented realistically to students is a big one that I'm not really seeing mentioned.
part of how it excludes the disabled from joining the field is those aforementioned ptsd-inducing demands, but if it can do that to anyone imagine how that interacts with any type of marginalization, not just disability. though I do think specifically focusing on the disabled will behoove us here. if your raw daily functional hours, or your spoons, or your battery, whatever framework you prefer, is starting below your peers, and has additional drains on it your peers do not, with little to no implementation of accessibility to even pretend to account for that? good fuckin luck buddy. (20-40% of doctors may have clinically significant ptsd, but how many chronically ill patients do, dyou reckon?)
when my wife was in medical school, there was an "ethics unit" that I believe was mandatory but still treated as separate from the "real" classwork. I can't find the note I made about it at the time right now, but I recall the overall vibe being very "baby's first cripple" - basic things like how disability may affect more than just ability to independently get to appointments. even she, someone who fully identified as abled at the time and hadn't even really sat down to reckon with my own disability yet, was like "man this seems pretty basic, like almost insultingly so."
residencies need to stop working their residents to death. (resident unions need to prioritize working conditions not just pay.) medical schools need to stop making unreasonable academic demands as their primary basis for acceptance. clinics need to stop prioritizing the party line over patient outcomes.
none of this change will happen because the patients ask for it. that is literally the whole problem, that the medical system does not listen to the people who are dependent on it for quality of life or outright survival.
sometimes when you've been handed a shit situation, and you've been primed to approach a shitty way, you are going to have to stop, and catch yourself. you are going to have to make a conscious decision to treat your patients like human beings. you are going to have to start holding your colleagues accountable for not doing the same.
I am sympathetic to the burdens that medical school, residency, practice put on a doctor. I have dragged my wife through them, sometimes bodily. but you signed up for that. possibly without full informed consent, probably without adequate support, but it was a choice. and if you see this post, if you hear a patient expressing something like this, you have another choice to make.
you have to decide to improve. your patients cannot make that decision for you. but you get to make life-changing decisions for them, and you signed up to take that seriously. if you can't, you don't have to be a doctor. you get to walk away, yes even with all the student loan debt and disappointed family you can still walk away. we can't.
don't lie about the reliability of tests. don't assume a negative result means there's no problem. don't act like your patient's suffering is less important than your box-ticking. don't conflate "incurable" with "untreatable" or "undiagnosed" with "healthy" (or "healthy" with "happy").
I could go on and on and on, but ultimately the answer is we have been screaming and screaming about this, in public spaces, the entire time. it is there if you actually give enough of a damn to look. hell, you can ask me directly! I may not always be nice about it, but I get where you're coming from more than most patients and by god I will have fucking Thoughts for you. I am not joking, my inbox is always open.
