Supporting autistic doctors in primary care: challenging the myths and misconceptions

Abstract

From 2014 to 2017 autism was championed by the Royal College of General Practitioners (RCGP). A suite of resources were developed to support GPs in their care of autistic patients. 1 Engagement on this topic allowed the RCGP and GPs to be represented in national policy and guideline development.The RCGP continues to promote proper care of autistic patients, their families, and carers. In its position statement on the subject in June 2016 2 it recognised the essential role general practice plays in caring for this community, their families, and carers. It committed to promoting evidence-based training on autism, and to sign-posting resources that enable equitable access by this group to primary health care.The Core Capabilities Framework for Supporting Autistic People 3 and Reasonable Adjustments 'flag' on patient records mark out some of the significant progress that has been made. Much remains to be done, and although sensitivities to the needs of autistic patients have improved, the experience and needs of autistic doctors have gone, largely, unrecognised. AUTISM PREVALENCE IN HEALTHCARE PRACTITIONERSRecent prevalence data indicates 1.1% of the UK population is autistic, 4 although this is widely held to be an underestimate. While we do not yet have prevalence rates for autistic doctors, 1% of GP responders surveyed on this topic by the RCGP clinical priority group 5 indicated that they were themselves autistic, so informing their care of autistic patients.Public awareness campaigns, 6 medical literature, 7 or the diagnosis of a family member are prompting a 'lost generation' of autistic healthcare professionals to recognise their autistic traits, 8 but it is

A full CIRCLE: inclusion of autistic doctors in the Royal College Of Psychiatrists’ values and Equality Action Plan

“…One member who disclosed was simply told in writing that autism is incompatible with being a doctor. 5 Support from ADI, such as letters or attending fitness to practice meetings, has changed outcomes by informing, explaining and challenging out-of-date beliefs. Once implemented, we have seen examples within ADI of autistic doctors continuing their careers and thriving.…”

Neurodiversity in emergency medicine training: A double‐edged sword?

“…Empower all staff to give gentle, non‐judgmental feedback rather than making formal escalation the only pathway to resolution. Communicate consciously: time and resource pressures in ED frequently result in rushed and unstructured interactions. In these circumstances ‘social conventions and nuances of neurotypical norms may seem opaque, illogical or otherwise bewildering’ for the neurodiverse doctor 5 . Use of structured closed‐loop techniques and validated tools such as ISBAR to ensure effective and structured communication can be modelled and encouraged in all areas of the ED, not just the resuscitation bay.…”

“…Strategies to support the neurodiverse trainee within the ED In these circumstances 'social conventions and nuances of neurotypical norms may seem opaque, illogical or otherwise bewildering' for the neurodiverse doctor. 5 Use of structured closed-loop techniques and validated tools such as ISBAR to ensure effective and structured communication can be modelled and encouraged in all areas of the ED, not just the resuscitation bay. Be conscious to explicitly state, not just imply.…”

Autistic role modelling in medical education

“…Over recent years there has been growing interest in autistic medical students and doctors. Despite the fantastic work of the aforementioned advocates, the ability of autistic individuals to be successful medical practitioners and educators remains a novel concept to many doctors (3). Misunderstandings, such as the belief that autistic people lack in empathy or communication skills, can and have led to reports of discriminatory practice in general practice training within the United Kingdom (3).…”