When thinking of medical professionals, the typical adjectives used are intelligent, conscientious, dedicated, personable, and well read. For the most part, this is an accurate portrayal of most people involved in the medical community. However, when it comes to treating and relating to patients diagnosed with autism, many doctors, therapists, and others have limited knowledge or experience. Sadly, autism remains an isolated disorder in many respects, unless there is personal involvement through family or community. Medical professionals, like the rest of society, must be taught how to interact with members of the autism community and their families. Most formal curriculums are embracing autism in terms of having support programs for students on the spectrum, and in some cases providing job readiness and placement services.
There is a significant decline in the degree of attention given to adults with autism – perhaps none more glaring than the medical community. There have been reports of misdiagnoses among patients with autism resulting from poor communication and the lack of experience in treating those who present behaviors different from typical patients. In light of the vast array of behaviors found on the autism spectrum, it should come as no surprise that some doctors are simply lost when dealing with autistic patients. HINT: People with autism won’t always tell you what’s wrong with them. Some patients can’t identify, much less articulate, the nature of their discomfort. Due to sensory challenges, some individuals with autism can’t tell the difference between a dull aching pain or a sharp stabbing pain. Moreover, some have difficulty locating where pain or discomfort is coming from because of constant tingling or other bodily sensations. Explaining what’s going on with their body to a stranger in an environment where uncommon noises, smells, and other people are present can be extremely stressful. The challenge is only exacerbated if the patient is non-verbal or has minimal verbal capacity.
In order to identify the source of disconnect between the autism and medical communities, we must first examine the current state of health care. According to the American Association of Medical Colleges (AAMC), there are concurrent forces brewing to make this arguably the most challenging time in history for physicians. The results of an April 2018 study conducted by the AAMC indicated there will be a shortage of 120,000 doctors by 2030. The primary factors driving this trend are an aging population, health care management, and doctors reducing their working hours. We are aware of aging populations in developed countries around the world and the enormous task of providing adequate health care. Additionally, managed care has long been debated in both highly favorable terms and viewed as the catalyst for everything wrong with modern health care. The third reason stated above is somewhat surprising as a driving factor contributing to the doctor shortage. The study conducted by the AAMC concluded work life balance was a major reason many younger professionals are choosing to leave careers as doctors or seek alternate employment options. Moreover, the crushing debt load many new doctors carry upon leaving medical school is a major area of concern for new prospects. Not all challenges associated with training and retaining doctors are industry related, however.
Researchers anticipate the US population to grow by 11% by the year 2030. It is particularly interesting to note where future growth will occur and its impact on health care. Individuals 18 years old and younger will only increase 3% during the same time period, while those 65 and older will grow 50%. Even more daunting is the fact that adults 75 and older will increase by 69%. Given those staggering numbers regarding the general population, is there any wonder as to the level of concern surrounding future health care? More poignantly, current health care trends ignore the emotional and psychological needs of autistic adults. Parents fulfill many of these needs, but adults on the spectrum are largely misunderstood by members of the medical community. This is not an indictment of physicians, but more of a reality check.
Maintaining a successful medical practice or working in a facility requires a great deal of diligence, while balancing stress and responsibilities. One of the consequences of living in an aging society is making adjustments on various levels. As aging boomers move towards assisted living and nursing homes, those with special needs children will interact with other members of society representing long term care, financial services, health care, and housing sectors. Doctors will see more patients on the autism spectrum as we move along the continuum. Learning to communicate effectively with the autism community and discovering the nuances of autism will be an integral part of patient care. In order to achieve that goal, we must all learn new skills and maintain an open mind. Fortunately, both health care and the autism community are leaning heavily on technology to assist with all aspects of living. Embracing the shared use of technology may be the optimal place to start a long mutually respectful relationship.