Originally issued by the UC Davis Health System
ANN ARBOR, Mich. — Deaf and hard of hearing (DHoH) people had traditionally had to overcome significant professional barriers, particularly in health care. A number of accommodations are available for physicians with hearing loss, such as electronic stethoscopes and closed-captioning technologies, but are these approaches making a difference?
A team of researchers from the University of Michigan, University of California, Davis, and the University of Texas Health Science Center at San Antonio surveyed DHoH physicians and medical students to determine whether available accommodations enhance career satisfaction and DHoH providers’ ability to deliver care.
The research has important implications for medical students, educators, employers and DHoH patients, authors say.
“This study highlights a little understood but clearly growing group of physicians who are demonstrating that hearing loss doesn't keep them from being a physician,” says senior author Philip Zazove, the George A. Dean, M.D., Chair of Family Medicine at the University of Michigan Medical School. “These doctors connect with DHoH patients in a way that hearing physicians can't.”
The article, titled “Deafness Among Physicians and Trainees: A National Survey,” appears in the February 2013 issue of Academic Medicine.
“We found that many deaf and hard-of-hearing students and physicians are interested in primary care practice and serving hearing-impaired patients," says co-author Darin Latimore, director of student diversity at UC Davis School of Medicine. “By ensuring access to training for more physicians, we can enhance diversity within the health-care profession and improve care for underserved populations.”
The study showed that, while DHoH physicians were aided by accommodations, they spent significant amounts of personal time arranging for these tools. Institutional support was a critical lynchpin in determining job satisfaction among DHoH physicians and students. Prior to this study, little was known about DHoH physicians in the clinical workplace.
The team created an 89 question electronic survey that covered demographics, accommodations, job satisfaction and personal health. Recruitment was a big challenge, as there is no database for DHoH clinicians. To overcome it, the researchers adopted snowball sampling, in which participants recruit peers to take the survey. Ultimately, 86 medical students, residents and practicing physicians were identified and 56 completed the survey.
Of the participants, 73 percent described their hearing loss as severe or profound; with all but one having bilateral loss, meaning both ears have a loss of hearing. The majority of the practicing physicians (68 percent) were in primary care, while 23 percent of trainees planned to enter primary care. On average, practicing physicians reported caring for DHoH patients 10 percent of the time. The majority of trainees were uncertain what level of DHoH patients they would see.
“Our results confirm that DHoH medical students and physicians use a wide range of accommodations, implying that adapting accommodations to each individual's needs will be more successful than any single approach,” says lead author Christopher Moreland, assistant clinical professor at the University of Texas Health Science Center at San Antonio.
The most common accommodation was amplified stethoscopes (89 percent). Participants also used auditory equipment (32 percent), computer-assisted real-time captioning (21 percent), signed interpretation (21 percent) and oral interpretation (14 percent). The survey also examined phone use, which can be problematic for hearing-impaired physicians, and found the majority (56 percent) used amplified phones.
At the UC Davis School of Medicine, for example, a third-year student on a surgical rotation used tablet technology to link the sounds in the operating room to an off-site medical transcriptionist. The student was able to "listen" — in real time — to every word uttered by the surgeon performing the operation. The transcriptionist, working like a court reporter, received audio from the operating room and simultaneously typed the surgeon's words, which the student then watched on an overhead monitor while also observing — and even assisting when asked — the surgeon.
The survey also found that DHoH physicians and trainees invested a great deal of personal time arranging accommodations: submitting requests or coordinating with captionists or interpreters. While most spent around two hours per week making these arrangements, two medical students estimated they spent 10 hours each week arranging accommodations. Overall, participants appeared satisfied with their accommodations.
“Successful accommodations may contribute to career satisfaction,” added Moreland, who completed his medical residency at UC Davis and medical school at the University of Texas with the assistance of a sign-language interpreter. “This, combined with these physicians' relatively high interest in serving the DHoH community, suggests that recruiting and effectively training DHoH medical students may benefit the health of deaf and hard of hearing people.”
In addition to being the second largest disabled group of Americans, persons with hearing loss face disparities in cancer screening and other care and have a higher incidence of depression, making their medical needs a high priority.
Additional authors: Ananda Sen, Ph.D, research associate professor; Nora Arato, Ph.D, intermediate research area specialist, both of U-M.
Funding: This study was partially funded by the Health Resources and Services Administration.
Reference: February 2013, Academic Medicine, “Deafness Among Physicians and Trainees: A National Survey,” doi: 10.1097/ACM.0b013e31827c0d60