Research shows that female patients and those of ethnicity are more likely to be dismissed by doctors. Experts say: Keep asking questions.
Jenneh Rishe could do six miles in just 45 minutes until she suddenly couldn’t. In the spring of 2019, Mrs. Rishe, now 35, noticed that she found her daily jogs difficult.
A few years earlier, she had received a diagnosis of two congenital heart problems that she claimed doctors had told her wouldn’t affect her daily activities. But she was getting worse as chest pains became intense and kept her awake at midnight, and she was taking a wheelchair after falling out several times.
Mrs. Rishe, who lives in Los Angeles, found a highly-recommended cardiologist in the Midwest and flew to meet him. The doctor immediately disregarded the symptoms she explained. “People who have these heart conditions aren’t this sick,” she recalls his reply. He suggested the latest heart medication, advised her to get active, and sent her back home.
Unsatisfied with her care, the doctor was not satisfied with her care, and Mrs. Rishe visited a second doctor who conducted extensive tests, which revealed that her arteries were being spasmed due to the lack of oxygen. “I was having mini-heart attacks whenever I had chest pain,” she explained. After a few months, she underwent open-heart surgery to fix the issue and, she later discovered, could have saved her life.
“I constantly still think about how any run I went on quite literally could’ve been my last,” Mrs. Rishe told me.
Research has shown that diagnostic mistakes can occur in as many as one in seven interactions between a doctor and a patient. It is also believed that most of these mistakes result from the doctor’s inexperience. Females are much more likely to be misdiagnosed than males in various scenarios.
Patients who feel that their issues were incorrectly ignored as being minor or psychological by medical professionals are employing”medical gaslighting” or “medical gaslighting” to describe their experiences and share their experiences on social media sites such as Instagram. The term comes from the play “Gaslight” about a husband’s attempt to make his wife crazy. Many patients, especially women and those with a racial background, can describe the quest for precise diagnostics and treatment as grueling.
“We know that women, especially women of color, are often diagnosed and treated differently by doctors than men are, even when they have the same health conditions,” said Karen Lutfey Spencer, a researcher in medical decision-making at the University of Colorado, Denver.
Studies have revealed that when compared to women, women experience longer wait times before being diagnosed with heart disease and are being treated less vigorously in the event of a brain injury that is traumatic, which means they are more likely not to receive medication for pain. Patients of color typically receive less quality medical care. Doctors are more likely to refer to Black patients as uncooperative or unresponsive, as research suggests could impact the quality of treatment.
The majority of women say that doctors blame their health issues due to their mental health, being overweight, or the inability to take care of themselves, which can cause delays in the effectiveness of treatment. For example, Dr. Spencer’s research indicates that females are two times more likely than males to be diagnosed with a mental disorder when their symptoms match with heart health.
If Sarah Szczypinski, a journalist in Seattle, was suffering from knee swelling and pain in 2016, following the birth of her son. She said that a doctor had told her she suffered from postpartum depression. A different doctor advised her to shed weight and perform squats. But she suffered from hip dysplasia, which was exacerbated by pregnancy.
It was as if the doctors were saying that her severe discomfort “was something that a woman needs just to live through,” she explained. The problem was getting so powerful that it eventually needed surgery in 2020 to cut her leg bone split in half and to re-align it with her hip. After receiving a diagnosis, “I felt vindicated in many ways,” she declared. However, “it took three years to get a diagnosis and another two to heal.”
Certain people are more likely to be ignored and ‘gaslit.’
The misdiagnosis of women is more often than men, due to part because scientists have a much less understanding of women’s bodies than they know regarding the male body even. However, “there are biological differences that go down to the cellular level,” explained Chloe Bird, a senior sociologist at Pardee RAND Graduate School studying women’s health.
In 1977, the U.S. Food and Drug Administration started recommending that scientists exclude women in pregnancy from early clinical trials of drugs, citing that if women enrolled in the study were to become pregnant, the study could cause harm to their fetuses. Researchers also worried about hormonal changes that could distort research results.
Today — mainly due to a law adopted in 1993, which mandated that minorities and women be considered in medical research conducted through the National Institutes of Health -women are being more consistently involved in research, but there remain vast knowledge gaps.
In particular, females suffering from heart disease usually have distinct symptoms than men suffering from heart disease, and doctors are more familiar with male-specific symptoms, explained Dr. Jennifer Mieres, a cardiologist at Northwell Health in New York. If “women show up with symptoms that don’t fit into the algorithm we’re taught in medical school,” she explained the women are “gaslit and ignored.”
At the time, Michelle Cho, 32, was diagnosed with systemic lupus, the disease where the body gradually destroys its tissues. She was suffering from kidney failure and a heart murmur, and pneumonia. Yet the primary doctor she visited identified her as having allergies, she claimed she was allergic, and the next doctor believed she was pregnant.
“I left each time feeling disappointed, sad, and uneasy because I knew they had not solved my problem or helped me in any way, and it had been yet another wasted day,” said Ms. Cho, a New York City-based medical student. “It felt like they were saying, ‘It’s all in my head.'”
When Raimey Gallant is a writer 42 years old who lives in Winnipeg, she began losing weight, losing hair, and breaking out in an all-over rash in her 20s; her doctor had told her that she was “young, healthy and just lazy,” however, actually, later that year, she was diagnosed Graves’ disease, which is an autoimmune condition that causes the body to produce excess thyroid hormone.
Also, she battled for twenty years with regular periods before being diagnosed last year with endometriosis. This inflammatory condition is defined by the presence and appearance of endometrial tissue that extends outside of the uterus. “I’ll never get back the pieces of life I’ve lost to medical neglect,” she told the media.
How can patients and doctors improve their care?
It’s challenging to determine what steps to take to tackle these issues. That is what systemic experts say, but researchers say that, at a minimum, there should be more research conducted on women’s health.
Doctors must also get the chance to spend more time with patients, and they should see fewer patients in general, according to Dr. Spencer’s suggestion. Studies have shown that when individuals are engaged in multiple cognitive tasks and tasks, they tend to make impulsive decisions. A study showed that, for instance, physicians of males were more likely to prescribe painkillers to Black patients suffering from lower back pain if the doctors were under pressure.
Doctors often work under challenging circumstances, which “make it easy to make mistakes and oversights,” Dr. Spencer said. “It’s like a gauntlet of problematic systems and processes that invite bias.” Researchers have also called for increased education in medical schools about unconscious discrimination and prejudice in healthcare. In 2019, California passed a law requiring hospitals to implement an implicit bias training program for all health professionals who offer perinatal care.
In the meantime, in the future, women, and patients of color might think about bringing someone close to them to the doctor’s appointments, according to the doctor. Alyson McGregor, co-founder and director of the Sex and Gender in Emergency Medicine division at Brown University. “It helps if you have an advocate there that can intervene and say things like, ‘She is not normally in this much pain,'” she explained.
“see another doctor if you feel dismissed,” Dr. McGregor said. It is also possible to think about seeking out women-friendly doctors or a practitioner with a higher level of cultural competency who can better “understand your perspective and language.”
After four months of Mrs. Rishe’s operation, She wrote an open letter to the physician who had dismissed her complaints. “I drafted a whole message about how that interaction left me upset and that I felt tiny,” she wrote. She’s glad that the doctor she was dealing with is no longer part of her life, but she is concerned that she could be in the same situation with a different doctor in the future.
“It’s sad,” she added, “We go in on the defense and are ready for it to happen because it’s so common.”
