Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

Autism spectrum disorder and medicine: strengths, challenges, and stories

Arthur Lazarus, MD, MBA
Conditions
February 18, 2024
Share
Tweet
Share

Dr. Shaun Murphy (played by Freddie Highmore) stars in ABC’s The Good Doctor, a television drama that centers around an autistic surgeon whose job at the hospital was frequently threatened and would be lost if it were not for the practical and emotional support from the hospital president.

I don’t know how many “Doctor Murphys” practice medicine in real life – autism spectrum disorder (ASD) prevails in about 1% to 2% of the general population – but I do know that ASD is a complex neurodevelopmental disorder characterized by two main types of symptoms:

1. Social communication and interaction challenges: People with ASD often have difficulty with social aspects of communication and interaction. This can include:

  • Difficulty with social-emotional reciprocity, such as initiating or responding to social interactions.
  • Challenges in nonverbal communicative behaviors used for social interaction, like eye contact, body language, or understanding and using gestures.
  • Difficulty in developing and maintaining relationships appropriate to the developmental level.

2. Restricted, repetitive patterns of behavior, interests, or activities: People with ASD may display behaviors, interests, or activities that are restricted and repetitive. This can include:

  • Stereotyped or repetitive motor movements, use of objects, or speech.
  • Insistence on sameness, inflexible adherence to routines, or ritualized patterns of verbal or nonverbal behavior.h
  • Highly restricted, fixated interests that are abnormal in intensity or focus.
  • Hyper or hypo reactivity to sensory input or unusual interest in sensory aspects of the environment.

The severity and combination of symptoms can vary widely among individuals with ASD, hence the term “spectrum” was added to the diagnosis of autism in 2013. Symptoms of ASD are typically recognized in the early developmental period, but they may not fully manifest until social demands exceed the individual’s capacities. Symptoms can also be masked by learned strategies in later life, but individuals may suffer from the stress and effort of maintaining a socially acceptable façade.

This last point, i.e., symptoms may be masked in adulthood, weighs heavily, because I can see myself as an outlier on the autistic spectrum. Not too long ago, a colleague who knows me well suggested half-kidding that I may have had autism as a child.

“No way,” I said

“Think about it,” she replied. “You don’t socialize much, you have rituals (two showers a day), you’re rigid and set in your ways, and you’re fixated on your hobbies. I bet if we gave you the ADOS-2 (Autism Diagnostic Observation Schedule, Second Edition), you’d come out on the spectrum.”

I was speechless. I revisited the DSM criteria for autism spectrum disorder and researched some of the characteristics that may potentially correlate with or predispose someone to a career in medicine. Here is what I found:

1. Attention to detail: Many individuals with ASD have an exceptional ability to focus and pay attention to detail. This can be particularly useful in medicine, where precision and meticulousness are crucial.

2. Strong memory skills: Some people with ASD have excellent memory skills, particularly for factual information or processes. This could be beneficial in a medical profession where remembering large amounts of information is required.

3. Systemizing tendency: People with ASD often have a strong interest in systems. This can translate into an interest in the human body’s systems and a passion for understanding how they work, which is a fundamental aspect of medicine.

4. Perseverance: Many people with ASD can be exceptionally determined and persistent, especially when they are passionate about a particular subject. This trait can be very advantageous in the demanding field of medicine.

5. Honesty and directness: Individuals with ASD often have a straightforward and honest communication style. While they may need to develop soft skills for patient interactions, their honesty can be an asset in a profession where transparency and integrity are valued.

ADVERTISEMENT

6. Special interests: People with ASD often have intense special interests. If their interest lies in the field of medicine, they could excel in this field due to their ability to focus intensely on their area of interest and specialization.

Until recently, there has been little research into the experiences of autistic doctors. However, a 2023 survey of 225 physician members of the U.K.-based support group Autistic Doctors International, representing about 45% of its membership, shed light on challenges faced by neurodivergent doctors in their profession. The findings are shocking:

  • 24% have attempted suicide
  • 77% have contemplated suicide.
  • 49% engaged in self-harm

The average age of a formal diagnosis of autism for doctors was 36 years old, confirming that high intellect and specific aptitudes – in this instance, aptitudes viewed as medical “assets” – may explain why signs can go undetected for years and mask the diagnosis in adults.

There have always been autistic doctors, but this survey revealed that the field of medicine is extremely challenging for the neurodivergent clinician to navigate. The survey also highlighted the need for greater support and understanding of autistic doctors – and autism in general – within the medical community.

Indeed, a 2019 study demonstrated that medical students report low knowledge of ASD, and more than 90% of students cite inadequate preparation for caring for individuals with autism. Medical students also reported a greater need for increased education and training in ASD care.

Although a diagnosis of autism can have unfavorable consequences if individuals are met with denial or discrimination from employers, the condition is not a reason for organizations to impede the successful practice and career progression of doctors with ASD. Like the good Dr. Murphy, a successful career in medicine is possible for doctors on the autistic spectrum if the condition is recognized and supported sooner and appropriate accommodations are made.

I don’t doubt I share some of the disorder’s features with individuals who fall on the autistic spectrum. Considering that ASD is a spectrum disorder, meaning characteristics can vary greatly from person to person, not all individuals with ASD will have these traits, and having these traits does not necessarily mean an individual with ASD will want to or be able to become a doctor.

To be clear, I was never diagnosed with an autism spectrum disorder. Reflecting on the possibility, I feel a bit like psychologist Malcolm Crowe (played by Bruce Willis) in The Sixth Sense. Dr. Crowe doesn’t recognize he is dead until the end of the movie. I’m quite alive, but the thought I might have ASD is quite unimaginable, even if it were true. Receiving the correct diagnosis – in the field of psychiatry, especially – can be a moment of sudden enlightenment and explain a lifetime of difficulties.

Arthur Lazarus is a former Doximity Fellow, a member of the editorial board of the American Association for Physician Leadership, and an adjunct professor of psychiatry at the Lewis Katz School of Medicine at Temple University in Philadelphia, PA. He is the author of Every Story Counts: Exploring Contemporary Practice Through Narrative Medicine and Medicine on Fire: A Narrative Travelogue.

Prev

Mastering the art of efficient patient encounters: tips for physicians

February 18, 2024 Kevin 0
…
Next

The medical profession's silent struggle: Business knowledge matters

February 18, 2024 Kevin 1
…

Tagged as: Neurology

Post navigation

< Previous Post
Mastering the art of efficient patient encounters: tips for physicians
Next Post >
The medical profession's silent struggle: Business knowledge matters

ADVERTISEMENT

ADVERTISEMENT

ADVERTISEMENT

More by Arthur Lazarus, MD, MBA

  • In a fractured world, Brian Wilson’s message still heals

    Arthur Lazarus, MD, MBA
  • 5 years later: Doctors reveal the untold truths of COVID-19

    Arthur Lazarus, MD, MBA
  • How a $75 million jet brought down America’s boldest doctor

    Arthur Lazarus, MD, MBA

Related Posts

  • How social media can advance humanism in medicine

    Pooja Lakshmin, MD
  • Is medicine right for you? Exploring the benefits and challenges of a health care career.

    Timothy Dillinger
  • The difference between learning medicine and doing medicine

    Steven Zhang, MD
  • From penicillin to digital health: the impact of social media on medicine

    Homer Moutran, MD, MBA, Caline El-Khoury, PhD, and Danielle Wilson
  • Medicine won’t keep you warm at night

    Anonymous
  • Delivering unpalatable truths in medicine

    Samantha Cheng

More in Conditions

  • Why gambling addiction is America’s next health crisis

    Safina Adatia, MD
  • How robotics are reshaping the future of vascular procedures

    David Fischel
  • How the shingles vaccine could help prevent dementia

    Marc Arginteanu, MD
  • Why removing fluoride from water is a public health disaster

    Steven J. Katz, DDS
  • What the research really says about infrared saunas

    Khushali Jhaveri, MD
  • How the cycle of rage is affecting physicians—and how to break free

    Alexandra M.P. Brito, MD and Jennifer L. Hartwell, MD
  • Most Popular

  • Past Week

    • Why Medicaid cuts should alarm every doctor

      Ilan Shapiro, MD | Policy
    • When the diagnosis is personal: What my mother’s Alzheimer’s taught me about healing

      Pearl Jones, MD | Conditions
    • 2 hours to decide my future: How the SOAP residency match traps future doctors

      Nicolette V. S. Sewall, MD, MPH | Education
    • Key strategies for smooth EHR transitions in health care

      Sandra Johnson | Tech
    • Reassessing the impact of CDC’s opioid guidelines on chronic pain care [PODCAST]

      The Podcast by KevinMD | Podcast
    • Why removing fluoride from water is a public health disaster

      Steven J. Katz, DDS | Conditions
  • Past 6 Months

    • Why tracking cognitive load could save doctors and patients

      Hiba Fatima Hamid | Education
    • What the world must learn from the life and death of Hind Rajab

      Saba Qaiser, RN | Conditions
    • The silent toll of ICE raids on U.S. patient care

      Carlin Lockwood | Policy
    • “Think twice, heal once”: Why medical decision-making needs a second opinion from your slower brain (and AI)

      Harvey Castro, MD, MBA | Tech
    • Why we fear being forgotten more than death itself

      Patrick Hudson, MD | Physician
    • Bureaucracy over care: How the U.S. health care system lost its way

      Kayvan Haddadan, MD | Physician
  • Recent Posts

    • Why gambling addiction is America’s next health crisis

      Safina Adatia, MD | Conditions
    • When did we start treating our lives like trauma?

      Maureen Gibbons, MD | Physician
    • How robotics are reshaping the future of vascular procedures

      David Fischel | Conditions
    • Medicalizing burnout misses the real problem

      Jessie Mahoney, MD | Physician
    • How the shingles vaccine could help prevent dementia

      Marc Arginteanu, MD | Conditions
    • How to survive a broken health care system without losing yourself [PODCAST]

      The Podcast by KevinMD | Podcast

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

Leave a Comment

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

ADVERTISEMENT

ADVERTISEMENT

ADVERTISEMENT

  • Most Popular

  • Past Week

    • Why Medicaid cuts should alarm every doctor

      Ilan Shapiro, MD | Policy
    • When the diagnosis is personal: What my mother’s Alzheimer’s taught me about healing

      Pearl Jones, MD | Conditions
    • 2 hours to decide my future: How the SOAP residency match traps future doctors

      Nicolette V. S. Sewall, MD, MPH | Education
    • Key strategies for smooth EHR transitions in health care

      Sandra Johnson | Tech
    • Reassessing the impact of CDC’s opioid guidelines on chronic pain care [PODCAST]

      The Podcast by KevinMD | Podcast
    • Why removing fluoride from water is a public health disaster

      Steven J. Katz, DDS | Conditions
  • Past 6 Months

    • Why tracking cognitive load could save doctors and patients

      Hiba Fatima Hamid | Education
    • What the world must learn from the life and death of Hind Rajab

      Saba Qaiser, RN | Conditions
    • The silent toll of ICE raids on U.S. patient care

      Carlin Lockwood | Policy
    • “Think twice, heal once”: Why medical decision-making needs a second opinion from your slower brain (and AI)

      Harvey Castro, MD, MBA | Tech
    • Why we fear being forgotten more than death itself

      Patrick Hudson, MD | Physician
    • Bureaucracy over care: How the U.S. health care system lost its way

      Kayvan Haddadan, MD | Physician
  • Recent Posts

    • Why gambling addiction is America’s next health crisis

      Safina Adatia, MD | Conditions
    • When did we start treating our lives like trauma?

      Maureen Gibbons, MD | Physician
    • How robotics are reshaping the future of vascular procedures

      David Fischel | Conditions
    • Medicalizing burnout misses the real problem

      Jessie Mahoney, MD | Physician
    • How the shingles vaccine could help prevent dementia

      Marc Arginteanu, MD | Conditions
    • How to survive a broken health care system without losing yourself [PODCAST]

      The Podcast by KevinMD | Podcast

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Leave a Comment

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...