According to data published in September by the Brazilian Federal Council of Medicine (CFM), 728 doctors with disabilities are registered on Brazil’s Regional Medical Boards (CRM). Almost half of these doctors have some form of physical or motor limitation. The survey is the product of the CFM’s efforts to better understand who these doctors with disabilities are and where they are based. For this purpose, the agency launched a campaign in 2016 to register these professionals. Since then, the CRM enrollment forms have included fields for collecting this information, and doctors who were already registered have been invited to update their information in the system.
Comparing Brazilian States
As of September 4, Minas Gerais was the state with the highest number of doctors with disabilities, based on CFM data. The survey results submitted by the agency to Medscape show that of the 728 professionals registered in the system, 137 are in Minas Gerais. This number accounts for 0.22% of the total number of doctors registered in the state. Next are Paraná, with 57 professionals (0.17%) and Rio Grande do Sul, with 50 doctors with disabilities registered (0.14%).
When we look at these numbers in terms of proportion, Roraima is the state with the highest percentage of doctors with disabilities (1.07%), followed by Acre and Espírito Santo, both with 0.32%. The CFM data include data from all Brazilian states except São Paulo.
The survey also shows that, of the 728 doctors who reported having a disability, 353 have motor disabilities, 148 have visual disabilities, 117 have hearing disabilities, and 110 have other types of disabilities.
Workplace Accessibility
The CFM’s initiative was one of the goals proposed by Sidnei Ferreira, MD, PhD, who was second secretary of the CFM at the time. In addition to registering doctors, the project also planned to improve accessibility inspections in Brazil’s healthcare units, to include the matter in the Code of Medical Ethics, and to create work groups or technical sectors for doctors with disabilities at the CRMs and CFM. The project envisaged holding periodic national forums, where the situation in Brazil could be explored and doctors with disabilities would have the opportunity to speak about the difficulties they face daily.
Ferreira, a pediatrician and professor at the Federal University of Rio de Janeiro, Rio de Janeiro, Brazil, and the current financial director of the Brazilian Society of Pediatrics, told Medscape Medical News that the CFM approved all the proposals.
He explained that each regional board inspects the healthcare services in its respective state. “The system checks, for example, whether more doctors are needed at the healthcare units, whether there are medications, among other things. However, until now, the issue of hospital accessibility for doctors and patients with disabilities was not in the inspection guide.” Based on Ferreira’s project, the CFM’s resolution governing inspection actions was updated and now includes this issue.
The new inspection guide, drafted by Ferreira and his collaborators, was tested in Rio de Janeiro in a joint project with the State of Rio de Janeiro Regional Medical Board. Twenty-four healthcare units were evaluated in the first half of 2016.
The authors analyzed various aspects of the buildings, including the existence and suitability of ramps, stairs, elevators, suspension points, floor markings to guide the visually impaired, doors, parking, building entryways, floor access, cafeteria, restrooms, and surgical centers. The results showed that none of the healthcare units had suitable accessibility.
The same study also evaluated four of Rio de Janeiro’s medical schools and identified only two adapted for persons with disabilities. These findings were presented at the 15th Bioethics National Conference held in Portugal in 2018.
Acute Awareness
The 2016 proposal also led to inclusion of the matter in the current Code of Medical Ethics. Since 2019, the publication has included a chapter titled “Doctors’ Rights,” and one of the articles emphasizes that “it is the right of the doctor with disabilities or illness, within the limits of their abilities and that of patient safety, to exercise their profession without discrimination.”
Raymundo Soares de Azevedo Neto, MD, PhD, pathologist and professor at the University of São Paulo, São Paulo, Brazil, has walked with the aid of crutches since childhood due to paraplegia and scoliosis. His condition results from a case of poliomyelitis that he contracted at 9 months old during an epidemic of the disease in his city of birth, Uberaba, Minas Gerais. After the diagnosis, his parents moved to São Paulo, where he eventually earned his medical degree. “It was wonderful to be in a place like São Paulo that gave me so many opportunities even though my physical abilities are somewhat limited,” he pointed out in an interview with Medscape.
Azevedo Neto also told Medscape that throughout his entire journey, he never felt rejection from his patients or family members. “They have always seemed confident in me and accepted the proposed conduct. With this, I have always had good doctor-patient relationships. In this sense, I feel completely fulfilled professionally,” he said.
In Azevedo Neto’s opinion, one of the most essential elements of professional fulfillment for a person with disabilities is to have an acute awareness of what they can and cannot do. This is true for any profession, not just medicine. “I cannot, for example, carry a patient. It is not prudent for me to work alone. It is always best for me to be with a team to do certain maneuvers that I wouldn’t be able to do by myself,” he said, remembering that, as for all physicians, he has always been able to count on the presence and support of his team members. “We have to assume this responsibility as professionals and safeguard the patient from risk,” he stated.
Azevedo Neto also stated that there have been many advances concerning accessibility in general in the city of São Paulo, which is crucial for inclusivity. “It is essential to make environments accessible. If you have intellectually able, specialized professionals with certain characteristics that make their training more challenging but who have managed to reach their goals and achieve this professional level, you must create the appropriate conditions whenever necessary in the hospital, clinical, or outpatient setting. You have to adapt the environment so that they can exercise their profession,” he said.
Nevertheless, according to Ferreira, “advances are still needed with regard to accessibility, especially when it comes to the country’s buildings and public spaces and healthcare services.”
This article was translated from Medscape’s Portuguese edition.
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