The Consequences Of Medical Misdiagnosis

How Sexism In The Healthcare Industry Is Hurting Women

WHAT YOU CAN DO...

  • Lobby for changes in medical school curriculums to move away from a solely diagnosis-oriented approach and teach doctors to not discount patients’ reports of pain by contacting the Association of American Medical Colleges https://www.aamc.org/

  • Spread awareness of this bias among healthcare providers by calling for more scrutiny from healthcare quality and ethical reviewers by contacting the Joint Commission on the Accreditation of Healthcare Organizations (JCAHO) https://www.jointcommission.org/report_a_complaint.aspx

  • Contact your Representative about including women in tests conducted by all healthcare organizations and expanding the NIH 1993 Act to ensure that female and male results are studied separately to allow for proper scrutiny and differentiation

By Josette Barrans

In America, there is an epidemic of women being systematically misdiagnosed by healthcare providers. Women are consistently not given strong enough medication or urgent enough care for their true conditions. Their pain is not taken as seriously as men’s, even being reduced to “female hysteria.'' Not only is this sexist, it forces women to endure more unnecessary pain or face even worse consequences. The last policy which attempted to address this issue was a section in the NIH Revitalization Act of 1993 in which Congress ordered the National Institute of Health to include women in all of its clinical trials[1]. But this did not solve the knowledge gap in women’s medicine. Most studies lump data from all participants together and fail to compare women’s and men’s results separately[2]. As a result, doctors are not focusing in on how women specifically are affected by certain diseases and conditions. Consequently, there are no current policies actively working to prevent the misdiagnosis epidemic affecting female patients. Additionally, drug companies and medical device manufacturers are not required to follow the 1993 rule, meaning women are not accurately represented in their studies[3]To solve this issue, policies are needed that address the knowledge gap of female health starting in medical school curriculums and extending to include women in studies conducted by all healthcare providers.

        In a recent report, a woman underwent eight rounds of electroconvulsive therapy (ECT) because she was misdiagnosed with severe depression and other psychiatric issues. This ECT was essentially forced upon her, despite the woman’s consistent protests that she didn’t have depression, and made her lose around six years of her memory. After continuously begging her doctors to reexamine her, they discovered that she had myalgic encephalomyelitis (ME/CFS), an autoimmune disease that affects many bodily systems. Though it can cause up to 60 differentsymptoms, ME/CFS is often ignored by doctors, with some even believing that it is fake[4]. Consequently, this woman was put through extreme pain and suffering simply due to the inability of her doctors to take her seriously. Her story is not a one-off; countless women in our nation needlessly suffer due to sexism embedded into America’s healthcare system which prevents them from obtaining the treatment they need.

        One prominent example of this epidemic is women suffering from chronic pain. These women are much more likely than men to be given sedative prescriptions rather than pain medication[5]. In fact, research has shown that women experience and report greater and more frequent pain than men[6]. Yet women are consistently treated for pain less aggressively since doctors often hold misperceptions that women are more prone to overreacting and hysteria[7]. This attitude seeps into public discourse as well, causing people to think that women are not accurate portrayers of their pain, essentially discrediting their knowledge of both themselves and their body. It is also typical for women with chronic pain to have no clearly definable conditions, which often leads to doctors taking the easy way out by diagnosing them with a mental health disorder[8]. This indifferent approach not only continues the suffering of the women in pain but  also delegitimizes mental health disorders by making them an extraneous category that women with no clear condition can be lumped into.

        Even more serious medical emergencies are consistently misdiagnosed in women. Women are seven times more likely than men to be misdiagnosed while suffering a heart attack and be discharged from the hospital during the emergency[9]. This can lead to lifelong repercussions or even death. One of the main causes of these mistakes is doctors being taught to recognize symptoms and make diagnoses based on understandings of male physiology. Since women can have completely different symptoms than men for many conditions, including heart attacks, many healthcare providers are not equipped to recognize them. This lack of knowledge costs women dearly. Considering that women represent over half the population, doctors should be taught how to perceive diseases and health issues in both women and men.

        There are many contributing factors for this problem that must be addressed. For instance, even though 78% of healthcare professionals are women, the higher positions are usually filled by men[10]. If more women were making these important decisions, there would likely be less misdiagnoses or dismissals of female patients. This disparity is likely a product of the gender discrimination that still exists in hiring practices, so healthcare organizations need to make a concious effort to make sure women are getting a seat at the table. There also need to be sweeping changes to how medical schools teach symptom recogniziation so that lessons always include both male and female versions of symptoms. There must be more emphasis on evidence-based diagnosis and general awareness of this gender bias in the medical field. Doctors should be trained to take what their patients say into account, and consider their reports of pain seriously. Furthermore, there must be more scrutiny from healthcare quality and ethical reviewers on this issue. One organization that oversees this is the Joint Commission on Accreditation of Healthcare Organizations (JCAHO), which accredits more than 21,000 US health care organizations. JCAHO has on online form where one can report a patient safety concern or event at a hospital, which could be used as a platform to draw attention to instances where gender bias prevent a woman from receiving proper care[11]. We must also call on Congress to extend their policies to force all healthcare organizations to include women in their studies so that their needs can be properly served.

        Doctors must start believing women and be more willing to admit that they may not be an expert on female symptoms instead of pushing false diagnosis and treatment on these patients. Bringing in specialists can easily solve most of these diagnostic problems, rather than searching for the quickest and easiest solution. Additionally, policies are needed that close the knowledge gap by forcing companies in all industries to include women in their studies and focus on their results and reactions separately from men. Clearly, the idea of a one-size-fits-all solution has been hurting women, as the standard of medicine is typically designed around men. Women are suffering, and even dying, because of sexist doctors and healthcare practices; this must be put to a stop.

 

 


[1] “Including Women and Minorities in Clinical Research Background.” National Institutes of Health, U.S. Department of Health and Human Services, 2019. https://orwh.od.nih.gov/research/clinical-research-trials/nih-inclusion-policy/including-women-and-minorities-clinical

[2] Sagon, Candy. “Women's Health Issues And Medical Gender Bias.” AARP, 2017, www.aarp.org/health/conditions-treatments/info-2016/womens-health-gender-bias-cs.html.

[3] Sagon.

[4] Hirsch, Michele Lent. “9 Rounds of Electroshock Therapy. 6 Years Lost. All Because Her Doctors Got It Horribly Wrong.” Cosmopolitan, Cosmopolitan, 22 Jan. 2019, www.cosmopolitan.com/health-fitness/a25362145/electroshock-therapy-misdiagnosis/.

[5] Kiesel, Laura. “Women and Pain: Disparities in Experience and Treatment.” Harvard Health Blog, Harvard Health Publishing, 7 Oct. 2017, www.health.harvard.edu/blog/women-and-pain-disparities-in-experience-and-treatment-2017100912562.

[6] Hoffmann, Diane E. and Tarzian, Anita J., The Girl Who Cried Pain: A Bias Against Women in the Treatment of Pain (2001). Journal of Law, Medicine & Ethics, Vol. 29, pp. 13-27, 2001. https://ssrn.com/abstract=383803

[7] Seegert, Liz. “Women More Often Misdiagnosed Because of Gaps in Trust and Knowledge.” Association of Health Care Journalists, 16 Nov. 2018, healthjournalism.org/blog/2018/11/women-more-often-misdiagnosed-because-of-gaps-in-trust-and-knowledge/.

[8] Hirsch.

[9] Kiesel.

[10] Joyce, Trish. “Does Healthcare Have a Gender Problem?” Health ECareers, Everyday Health Group, 24 Apr. 2018, www.healthecareers.com/article/healthcare-news/does-healthcare-have-a-gender-problem.

[11] “Report a Patient Safety Concern or Event.” Jointcommission.org, www.jointcommission.org/report_a_complaint.aspx.