December 3rd is the UN-sanctioned International Day for Persons with Disabilities. Observing this day aims to promote an understanding of disability issues and to mobilize support for the dignity, rights, and well-being of people with disabilities. In 2017, the Canadian Survey on Disability estimated that 22 per cent of Canadians 15 and over had a disability; most had two or more types of disabilities. As medical staff, we encounter and care for people with disabilities—visible and/or invisible—often.

Family physician Dr. Jen Chen recently took on a patient who is deaf and she has made accommodations in her practice so her patient can have better access to health care. This was the inspiration behind Dr. Chen’s recent presentation at the EDI Journal Club+. The group, which is organized by the VCH Medical Staff Equity, Diversity and Inclusion Committee, welcomes all medical staff, and the goal of each meeting is simple: improve patient care by incorporating evidence into practice.

“The topic for discussion was invisible disability and specifically supporting equity and inclusion of deaf and hearing-impaired individuals,” said Dr. Chen. “We were fortunate that one of the participants was an ear, nose and throat specialist who is passionate about this topic.”

Dr. Chen shared a summary of studies regarding outcomes among the deaf community because of inadequate access to health care. These range from poor knowledge and practice of oral dental care to inadequate access to end-of-life care. Barriers to better care include inadequate policies of providing sign language interpreters, social exclusion, limited access to health info, and oral and printed language barriers. Added to this, many health-care providers do not understand how to improve communication with deaf patients.

“The onus is on us as health-care providers to be more inviting and to make it easier for people to attend appointments,” said Dr. Chen. “We have a lot to improve on—not just us doctors, but our receptionists as well. We all would benefit from more training in this area.”

Dr. Chen shared inclusion strategies for caring for patients who are deaf or hard of hearing. These include:

• Be patient and open to adaptation.
• Be open to writing.
• Have visuals.
• Caption video and audio content.
• Provide accessible technology in the workplace.
• Have online scheduling options.
• Always speak to patients directly and make eye contact.
• Provide clear masks.

“Covid really advanced the use of technology in medicine,” she added. “It forced us to move ahead. With this patient, she can email to request appointments and she can text me. She can lip read a bit, so I take my mask off when talking to her. And we type messages back and forth.”

Eight of the 14 medical staff attending the EDI Journal Club+ discussion completed the post-event evaluation and were largely positive in their appraisals. When asked what resonated with them most from the session, responses included:

• More awareness of how unseen disabilities impact practice and challenges they have on a patient’s already stressful health-care journey.
• The resources for helping with deaf patients, including addons for our iPhones.
• Amazing to have the ENT specialist attend and give practical suggestions.
• All the ways our systems are not inclusive for hearing-impaired individuals.
• This needs to be brought up a lot more as patients are left trying to fend for themselves if they have a hearing impairment.

Keep your eye on the weekly MSA/VPSA Checkup newsletter for the next meeting of the EDI Journal Club+ group. All VCH medical staff are welcome to attend.

The VCH Medical Staff EDI Committee is currently running a survey for VCH medical staff and residents living with disability. The intent of the survey is to learn about your experiences and potential actions that could make VCH a more inclusive, accessible, and welcoming organization. The information gathered will be used to inform future policies, practices, and interventions to improve diversity, equity, and inclusion at VCH. If you identify as experiencing disability, we encourage you to take the survey. The deadline has been extended until December 15 and two prizes (AirPods, 2nd Generation, or Fitbit Luxe) will be awarded to people who complete the survey and enter the raffle draw.