Many women report being ‘dismissed’ by doctors. The problems extend far beyond the exam room
By Amanda Schupak, CNN
(CNN) — One-third of women in the United States have struggled to get doctors to take their symptoms seriously, according to a new survey. And of those women, more than half said their health issues have affected their work and homelives.
Many Americans have inadequate access to quality healthcare, said Stephanie Marken, a researcher who worked on the survey, which was released Friday by Gallup and the organization Pivotal. But for many women, getting an appointment is “really half the battle.”
Once they have seen a provider, “they’re having a series of negative experiences at a much higher rate than men — things like feeling like they’ve been dismissed, or that their pain has been minimized, or that they’re leaving without the information that they need,” said Marken, a senior partner at Gallup.
Lingering health issues translate into missed opportunities at work or less time and energy for family, said Renee Wittemyer, a vice president at Pivotal, which was founded by philanthropist Melinda French Gates to advance social change for women.
The survey results show “the barriers women face in accessing healthcare, and how often those become barriers to opportunity, keeping them from living the lives they want,” Wittemyer told CNN.
‘This has been going on for centuries’
The survey asked 5,200 adults in the United States whether they had encountered any of four negative experiences with healthcare professionals in the past five years: feeling dismissed; receiving a misdiagnosis or no diagnosis; not getting clear answers or instructions; or getting conflicting advice. (Healthcare professionals could include doctors, nurses, physician assistants or other workers in a medical setting.)
More than half of women — 51% — said yes, compared with 39% of men. The most common complaint, reported by one-third of women, was that providers minimized or dismissed their symptoms or pain.
The disparity didn’t surprise Dr. Kimi Chernoby, an ER physician in Virginia. “We have a history of gender bias and not believing women,” said Chernoby, who is the chief legal officer of the FemInEM Foundation, a nonprofit that works to improve gender equity in emergency medicine. “Then we have surveys like this and no one should be shocked.”
A common tendency is to assume women are being dramatic or exaggerating when they describe symptoms of pain and discomfort, said Sahnah Lim, an associate professor at NYU Grossman School of Medicine whose research focuses on women’s health equity: “This has been going on for centuries.”
When medical professionals don’t heed their patients’ concerns, the consequences can be frustrating, dire or even deadly.
For instance, severe bleeding after giving birth, called postpartum hemorrhage, is one of the top causes of maternal mortality in the United States. The condition is preventable, but providers often don’t heed women’s initial reports of symptoms.
Healthcare providers also often miss heart attacks in women because they don’t present with the telltale chest pain that men do.
In the poll, women were far more likely than men to report fighting to have their health concerns taken seriously: 42% of women said they have had to speak up or advocate for their health, compared with 26% of men.
What’s more, men were diagnosed faster than women — even when they had the same medical condition.
Chernoby noted that it can sometimes be difficult for providers to reach a diagnosis, especially for pain syndromes and mental health conditions that can’t be objectively tested for.
“Then it becomes a question of, ‘Do you believe the patient in front of you?’ And the default for all of us should be, ‘Yes,’” she said. “But unfortunately, for a myriad of reasons, including the history of medicine and innate gender bias that permeates our medical system, it’s often not the case.”
Healthcare problems ripple outward
The potential fallout from a misdiagnosis or missed diagnosis can be catastrophic. The repercussions can also be subtle and insidious.
“Women are experiencing a very different healthcare system than men,” Marken said. “That’s having a significant impact on every aspect of their lives.”
Both men and women who said a provider had minimized or dismissed their symptoms were far more likely to report that their health has kept them from doing everything they wanted to in life.
Overall, though, women more often than men said their health issues have had a negative impact on their family, social lives or career. Of female respondents, 42% said their health has limited their work in some way in the past five years.
That finding was “pretty jarring,” Wittemyer said via email. “Just picture your own workplace and what it would mean if four in ten of the women there felt they had to work fewer hours or couldn’t pursue a promotion or new opportunity because of their health. That’s the reality.”
The figure was highest among Black women (49%) and Hispanic women (45%).
Prepare a priority list ahead of your medical appointment
To the millions of women who feel that medical professionals aren’t listening to them, Marken said, “Keep pushing.”
Dr. Wendy Harpham, whose new book, “Clinical Communication: Finding the Best Words to Inform, Comfort and Motivate Patients,” offers advice for how clinicians and patients can work together, said it helps to come to each appointment prepared with a list of questions and concerns to discuss.
Write it on a piece of paper or your phone, with the highest priority items at the top. Think through how you’ve been feeling so you can summarize your situation succinctly and efficiently in the limited time you have.
“It has to be a team effort for the doctor to get the information they need and for the patient to be heard,” she said.
If you’re at an impasse with your doctor, she said, it’s OK to cut ties and find someone you’re more comfortable with. Chernoby concurred, urging women to trust their instincts. “If something doesn’t sit right, get a second opinion,” she said. “People know their bodies. They know when something is wrong.”
But, the experts agreed, the onus shouldn’t be on women alone to fight for attention in a medical system that’s supposed to be taking care of them.
“It’s really not their issue. It’s a system issue,” Lim said. “There’s only so much advocacy one person can do for themselves.”
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