As the Americans with Disabilities Act (ADA) marks its 25th anniversary since its passage in 1990, healthcare organizations should consider the changing employment picture for physicians and its possible impact on ADA cases involving physicians. With more physicians choosing to be employed by large organizations rather than to work as solo practitioners, there will likely be more challenges under ADA regarding an employer's treatment of an impaired or allegedly impaired physician, says a commentary in the June 9, 2015, issue of the Journal of the American Medical Association. Under ADA, the term "disability" includes any impairment (i.e., physical, mental, behavioral), even if it is episodic or in remission, so long as that impairment would substantially limit a major life activity when active. To date, there have been only a few ADA cases involving physicians, so the commentary identifies common themes with regard to disability discrimination law that have emerged from judicial decisions applied to physicians and other health professionals. The commentary lists four ADA-related themes for healthcare organizations to consider in their employment of physicians: (1) assessment of impairment must be individualized; (2) decisions must be evidence-based and made by appropriate individuals; (3) technological advances must be considered in deciding whether an accommodation is reasonable; and (4) patient safety is critical, so recognize that courts will generally defer to carefully weighed decisions by professional programs, employers, and licensing agencies.

HRC Recommends: An organization's recruitment, selection, and retention processes, as well as its applications, advertising, job descriptions, interviews, preemployment testing, and postoffer medical examinations, must be considered in light of ADA requirements. Processes and procedures must be in place for making accommodations on a case-by-case basis. Risk managers should ensure that their organizations' hiring practices for physicians are consistent with ADA requirements and applicable case law.