Neurodiversity in General Practice

Neurodivergent individuals, including those with ADHD and autism, bring unique strengths to medical practice. However, without adequate support, they may struggle with the demands of general practice training. They may come into general practice training with a diagnosis, or somewhere on their journey of learning more about their neurodiversity.

ADHD is a disorder of regulation. Approximately 4% of Australians under age 45 have a diagnosis of ADHD. Cognitive, physical and emotional dysregulation all feature to some degree in all people with ADHD. Doctors with ADHD often have strengths in creativity and cognitive dynamism. They may have excellent problem-solving skills and have clinical courage. In general practice, they may be excellent diagnosticians and have the capacity to manage uncertainty. However, they may struggle with overly creative lists of differential diagnoses and be prone to over-investigation.

To have been successful in medical studies with ADHD, a doctor must have a high intellect and resilience. They often have high energy, take calculated risks and exhibit attention variability. They can excel in environments where quick thinking and adaptability are required. If undiagnosed and untreated, they may struggle with executive dysfunction, time management, organisation and attention. Exam preparation can be very challenging and ultimately impact success.

Autism is a difference of communication and affects approximately 1% of Australians. Autistic people often have strengths in attention to detail, ethics, rules and heightened sensory awareness. Again, these can be very beneficial traits for diagnostic medicine and creating evidence-based management plans. Autistic doctors are deeply empathetic (emotional empathy is over-developed while cognitive empathy is reduced) with obvious benefit in the general practice environment. Evidence has shown that when appropriately supported autistic people are highly productive.

Many neurodivergent doctors face stigma, with some reluctant to disclose their diagnosis due to fear of discrimination. In those undiagnosed, stigma can lead to a blind spot in professional awareness and personal development. With the constant demands of masking in an environment with high level communication, autistic doctors are at a higher risk of burnout. Anxiety and depression are much more common in the autistic population. In a recent survey by Autistic Doctors International, as many as 77% had ever considered suicide. Autistic doctors may misunderstand hierarchy and have been labelled as demanding, or troublemakers, having only been victim of “talking truth to power”.