Breaking down barriers
The UF College of Medicine’s first deaf medical student opens up about issues facing the Deaf community
In observance of National Deaf Awareness Month, the following is an essay crafted from an interview that staff writer Tyler Francischine conducted with Michael McKee, M.D. ’01. After graduating from the UF College of Medicine, McKee completed a residency in family medicine at Palmetto Richland Hospital in Columbia, South Carolina, and received a master’s in public health from the University of Rochester in New York, where he conducted research training in preventive cardiology. He serves as an associate professor in the University of Michigan department of family medicine and a physician at Dexter Family Medicine Center in Dexter, Michigan, where he leads the Deaf Health Clinic.
Sept. 25, 2019 — I was born with a profound bilateral sensorineural hearing loss due to a deaf gene. I was not officially diagnosed with a hearing loss until I was 2 years old, as this was before the implementation of the universal newborn hearing screening. I grew up doing speech reading and using hearing aids. I’m also fluent in American Sign Language. It wasn’t until the last year of my residency that I received a cochlear implant in my right ear.
While I was always drawn to biology, botany and environmental science, there were three key points that drew me to medicine. First, my grandmother was diagnosed with late-stage breast cancer. Her struggle with it — along with my family’s — made me keenly aware of the challenges patients and families face when a serious health problem arises. Second, my youngest brother was born at home when I was 19 years old. It was an incredible experience. Third, I was involved in several Deaf and hard-of-hearing community groups, and a common theme that came up was the ability to access health care. It made me realize I should consider a career in health care. Fortunately, I was able to connect with several mentors in the health care field, many of whom had experienced hearing loss themselves, who not only encouraged me but also gave me practical strategies to help overcome some barriers in medicine.
As their first deaf medical student, my training was a new experience for everyone at the UF College of Medicine. I vividly recall my first week and seeing how students and professors were unsure of how to best interact with me. To help put everyone at ease, I sent an email to the entire medical school describing myself, including my hearing loss and how I cope with it. I encouraged people to ask me questions. This was helpful in getting students to learn more about me and how to communicate with other individuals with hearing loss.
Unintentionally, my presence helped teach a cohort of future doctors about key accommodations and communication strategies with Deaf and hard-of-hearing individuals. Later in medical school, I hosted a Deaf Awareness Day in which Deaf and hard-of-hearing community members shared their health care interactions with my class. This is why we need diversity in our medical schools: The learning environment becomes richer as a result.
We also need to remember that diversity includes disability. One in five Americans identifies as a person with a disability, or PWD, and experiences significant health inequities. This population is larger than any other minority patient population that we care for. Yet, the efforts and focus in effectively caring for this group is woefully inadequate. PWD are rarely the focus in health care efforts, including research, education and employment, and they remain underrepresented in medical education and practice.
Medical students rarely receive training on how to appropriately communicate with, manage and care for this group. For example, many of our patients, especially older individuals, have a hearing loss, yet medical students and physicians are often unclear about how to communicate with them appropriately. I believe this results in adverse health care outcomes, including dissatisfaction among providers and patients. Fortunately, things are changing, including greater awareness and inclusion for these patients in what we do.
Many of my patients seek me out due to my openness about my hearing loss and knowledge in disability health. Some of our patients are looking for a physician who not only understands some of the struggles they are going through but who also has the cultural competency and clinical expertise to manage their health conditions. I naturally need to have good eye contact during patient visits to help me understand what they are saying. Many patients without a hearing loss or a disability love this and feel more connected to me as their health care provider.
Patients with disabilities are looking for physicians who are willing to listen to them. It is critical that we remain humble and understand that they are often the expert on their health, including their disabilities. This will allow for the opportunity to learn more about the impact of certain disabilities on one’s life and find ways to address their needs.