The Good Doctor and ADA

Caution: This post contains spoilers for seasons 1 and 2. So, don’t continue reading if you are going to be angry that I’m giving out spoilers.

 

The Good Doctor is my new show. I like medical dramas, even though they are utterly ridiculous. (The same surgeons are doing heart transplants, kidney transplants, brain surgery, and operating on 30-minute old babies. Also, they do all their own MRIs (never x-rays or CT scans), and the re are no laboratory employees. Just pathologists.) I get it; it would be a boring show if the doctors were only nephrologists or something. Plus, I would never get surgery at San Jose St. Bonaventure hospital because surely every minor thing results in a heart attack or a secret cancer diagnosis.

Anyway, I digress from my scheduled rant. The Americans with Disabilities Act.

The story follows Dr. Shaun Murphy, who has Autism and Savant syndrome. The actor, Freddie Highmore, does a brilliant job (in my opinion, which is not an expert one), portraying Dr. Murphy. The hospital board is a bit concerned about bringing him on-board because his Autism means struggles with relating to people.

But never once does ADA get mentioned.

Later, the new chief surgeon removes Dr. Murphy from surgery and places him in pathology. His reasoning is he is an excellent surgeon but cannot communicate well. When others complain that he will learn, the evil chief surgeon explains that because Dr. Murphy will always need help, he cannot do the job.

This is exactly the situation for which ADA exists. The question is,  “Can the employee (or candidate) do the essential functions of the job with or without reasonable accommodations?” And then you go through the interactive process.

It may well be that Dr. Murphy’s inability to communicate with patients effectively means he could never be an independent surgeon. I don’t know. I’m not a doctor and I don’t play one on the internet. But, I do know that the hospital will have one heck of a time winning in court if they didn’t attempt to find a reasonable accommodation.

And, that accommodation could continue for his entire career–not just through training. Could the reasonableness of an accommodation be different for a first year resident than for an attending? Absolutely. Are senior staff members not entitled to accommodations because they are senior people? Absolutely not. Accommodations apply at ever level of the organization.

At no point is HR consulted. At no point does anyone go to complain to HR. (HR does exist because, of course, two doctors go to register their sexual relationship with the nice HR lady, who tells them she believes they are lying but she will write down that they are not lying. Giant eye roll.) Surely HR would know about the austistic savant surgeon who is brilliantly saving lives. Surely a good CHRO would have had a conversation with the hospital president at the beginning of this whole thing.

Yes, yes, I know, the story line is the most important thing in a television show. But, if they wanted to do some advocacy for people with Autism, they could at least remind people that ADA exists and you need to comply with it.

But, to be fair, the lack of ADA compliance is far more believable than the actual medical cases, so I’m sure a real doctor could give a much better rant than I did on this. Do you think we could have a realistic hospital drama where the doctors only stuck to patients that they would actually care for? If so, I’m in.

Image by Sasin Tipchai from Pixabay

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4 thoughts on “The Good Doctor and ADA

  1. I love the Good Doctor too, and add my non-expert opinion to yours that Freddie HIghmore does a terrific job. I’m always amazed anyway at all the British actors perfectly capturing American English, but, here, HIghmore goes one further and adds specific speech traits relevant to his character’s autism diagnosis, such as hesitations suggesting social discomfort, monotone delivery (plus a flat affect). I, also, couldn’t understand the demotion to Pathology. Just about everything done on the show seems to be done by teams of doctors, not individuals. Couldn’t one of the other doctors take the lead in talking with the patients and their families, if Dr. Murphy’s bluntness were considered inappropriate? He’s portrayed as a brilliant, out-of-the-box, diagnostician and surgeon, capable of saving more lives than more-conventional thinkers. Shouldn’t he be on the lifesaving end, and not the post-mortem one?

  2. First of all excellent choice of show and if you think he does a great presentation in this show, look up his performance as Norman Bates in Bates Motel. As for your argument about how the ADA law is applied in this series especially the negative comments about how the effort to make accommodations in the workplace is typical of most American companies mainly due to the cost dollars in the labor column. In this case, the organization that funds the hospital (probably a for-profit), already feels that the doctor’s salary is already a cost, and to hire or assign a person who has the knowledge to tutor/mentor him in communication skills is not a necessary cost and will just past the problem on to his coworkers to adapt to his needs. In this situation of dealing with a person with autism, there was no real effort made to accommodate and I understand where the chief person in charge reasoning is on a first year resident (the position can be compared to a new hire who is supposed to have basic skills, observe, react, respond and interact). Because he is designated a savant, and hired by hospital, should have been meant accomodation were made. But the position is also where they weed out the best of the best, hence the no accomodation via ADA beyond minimum. Another medical show Chicago Med had an autistic establshed surgeon, Dr Isidore Latham, played by an excellent actor Ato Rssandoh, who set up his section of the hospital to meet his needs.
    By using the ADA law correctly as written, means accomodations that involve cost. It is easier on the dollar effect to do the least amount of accomodation within the letter of the law.

  3. Hmmm… I haven’t seen any of the show, but I’m in complete agreement based on this that they should have gone through the interactive process. Making stereotypical assumptions and high-handed decisions is not a great way to treat anyone. I mean, if he got through med school, at the very least challenging his ability to learn doesn’t hold up as an argument. And, quite frankly, neurotypical doctors aren’t always great at communicating either. 😀 Can’t remember where I was reading it, but some research or other was showing that NT folks and ND folks have normal communication with each other, and it’s just when you cross channels that it becomes challenging, so it’s rather like people who are able to be open to other cultures and communicate with people from all kinds of cultures will also probably do better communicating cross-neurodiversity…

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