How gender bias affects healthcare | Hacker News Reader

How gender bias affects healthcare

bbc.com

26 pointskunkurus36 comments

Meanwhile, men are accorded fewer visits at doctors (GP) in UK. 32% fewer visits compared to women:

http://bmjopen.bmj.com/content/3/8/e003320

http://news.bbc.co.uk/1/hi/health/8588686.stm

When I go to the GP she makes me feel like I'm intruding and wasting her time, like you're a man in your 20s, nothing could be wrong..

Maybe get a better GP?

Seriously, I've never encountered this attitude. Doctors seem to be generally fairly clinical and professional.

Young man here, happens to me all the time

In my experience it's not the doctors, who without exception have always been pretty good - but the clerical / reception staff. I've rarely been made to feel so unwelcome anywhere else. It's gotten to the point where I just stump up the cash and go private, although now I feel things have gotten better with the introduction of app based consultations via the NHS, which I'm registered for but haven't needed to try out yet.

That men don't go to the doctor as much as they should, and do more visits if they are married is well established.

Are you claiming that this fact is explained by the doctors actions and not by the gender norm that men should just bear with minor illness?

I think it's both. The GP doesn't seem to take you seriously if you appear to be a young healthy dude.

I once hurt my ankle really bad while doing surfing and the doctor made fun of me "being girly" and to go home and put some ice on it.

I just wanted to make sure there was nothing broken.

Only recently while thinking about it I realised how bad his attitude was and it certainly made me think at that time that it is in my head and I shouldn't go to the doctor.

I remember reading psychologist studies where doctors are twice as likely to diagnose a woman with depression compared to a man with an identical profile, and on average women have a higher chance of correctly getting an diagnose of depression.

I also remember seeing a study that sent identical profiles to general doctors but with the profile gender randomized. The result as I recall was that female patients were more likely to be believed in regard to pain and self-reported symptoms, but those men that did still get diagnosed were more likely to get active treatments.

It’s not clear if gender bias is the right word given that it’s such a loaded term. Women visit doctors more frequently and as the article states have higher rates of mood disorders. Given this, it seems obviously that misdiagnosis would be higher in women than men. It falls out of the Baysean statistics. If AI we’re doing the evaluation you could remove the gender parameter, but it could lead to even more frequent misdiagnoses. Alternatively we could be more exhaustive with diagnosing women but at what cost to the healthcare system? But then wouldn’t we be biasing against men? There is no free lunch here.

> ...it took another few years to find another set of doctors who would take her symptoms seriously. “I had a lot of, ‘You’re just hysterical,’ ” she remembers. “One of the more common things, especially in emergency rooms, was ‘You’re just drug seeking.’”

> As a woman of colour, Jackie was facing more than gender bias.

A friend of mine (black, female) was shooed away by doctors as "drug seeking" and later told she had lyme disease, was even put on a treatment for it before someone listened carefully and discovered the gigantic tumors growing on her liver!

Meanwhile I (white, male) went in for a 2-week cough that was keeping me up at night. Never been to this office or met the doc before but was given a script for codeine (!!) after about 2 minutes in the exam room.

Your story sounds worse to me -- you sought medical attention for a problem, received a dangerous drug with no meaningful diagnosis. I'm sure your insurance company still received a big bill for those 2 minutes.

I (white, male) have had similar experiences to your friend, minus the "drug seeking" accusation. Things like cysts and tumors are difficult to diagnose without imaging, and imaging is difficult to justify without symptoms. Lyme disease is often doctor-speak for "no idea".

If your friend, like you, had received a powerful narcotic painkiller instead of a diagnosis, might the painkillers have covered up her symptoms and caused her tumors to go unnoticed longer?

I'm very skeptical of the medical industry. Modern medical science is fantastic stuff but as an industry there is something seriously wrong. I think they over-prescribe painkillers on a scale few people would find believable. It's disappointing they aren't applying the skepticism your friend received universally across the board. It would do a lot of good if they did.

There might be bias at play, but this kind of different treatment happens to all sexes and races. It depends on doctors. I'd like to bring up people with ADHD being treated as drug-seekers, but I can't seem to find any real data on it. All I have are collections of anecdotes anyone could read up on by googling it and reading forums or simply reading reddit about it. On the other hand, that's going to be very biased.

So the way I see it, there's one of two (mostly useless) ways to eliminate gender bias.

The first is bias training, to get people to recognize and react to their implicit biases. You see one patient that is rude, non-compliant, etc, and you implicitly assume that patients that have the same features will act the same, and you act accordingly. This is usually within the context of racial bias ("the black patient isn't compliant, so all black patients must also not be compliant and thus I'll not give them the best care"). Not-so-fun-fact: most people hate going to these sort of training workshops (me included), and so I don't think these are very effective.

The second is having more women in healthcare. With cultural/racial/ethnic bias, we have seen a decrease in that bias when physicians of that culture/ethnicity are involved in that patient's care. Problem is, I don't believe this has worked all that well when applied to gender bias. You may argue that women are severely under-represented in areas of healthcare (surgery for example), and we should strive for there to be more female surgeons. However, look at obstetrics/gynecology in the US. We have a predominantly female workforce, and there's still bias against women during/after pregnancy. Look at how many patients presenting with symptoms of pre-eclampsia (leading to a potentially fatal condition HELLP) are missed or disregarded. What about the rates of pulmonary embolism after overlooked deep vein thrombosis symptoms post-childbirth?

The healthcare industry has in recent times made it hard to spend the time or resources needed to really "care" for a patient. Doctors have to keep their visits short to maintain their volume (and job), nurse shortages are prevalent, and everyone is overworked. I don't know if or when we're going to end up solving this problem, but maybe starting an honest conversation with colleagues will help.

Edit: changed some words for clarity.

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