Beyond the Exam Room: How does gender bias impact the treatment and testing of female patients?

Written by Dipika Dongerkery

Edited by Shane McGlone

Introduction

With the introduction of new technology, the medical field continues to advance allowing for more accurate medical treatment and diagnosis. Despite these advances, there are still factors that can impact the care that patients receive. One such factor is gender bias. Namely, women often receive subpar care when compared to their male counterparts. As we incorporate new procedures, treatments, and technology into the medical field, it is important that we ensure that all patients receive adequate care.

Examples of Disparity

Diabetes Diagnosis

A study conducted on diabetes diagnosis noted that women have delayed diagnosis in comparison to their male counterparts due to the lack of certainty. Delayed diagnosis puts patients at risk for further complications since diabetes is linked with high blood pressure, vision loss, skin conditions, and heart and kidney diseases. The study also highlights that it is important that women are taken seriously because despite women disclosing more information to their medical professionals, their concerns are undermined [1].

Pain Management 

The approach to female patients' pain also differs. Female patients receive fewer pain relief medications even while reporting similar issues. Coupled with the stereotypical biases that undermine the pain women face, causes nurses to record female patients' pain scores 10% less [2]. It is ironic especially when you consider the fact that 70% of people who suffer from chronic pain are women [3]. The lack of pain relief can impact the quality of life for these patients making it more difficult to complete day-to-day activities. 

Chronic Pain

Female patients have also expressed how they are not taken as seriously when they communicate their concerns. For instance, in a study, conducted on Australian women with chronic conditions an interviewee stated that “Often, I will get ignored about it anyway if I ask, if I'm having a particularly bad flare-up from time to time, because it does flare up from time to time. It's very hard to convince anyone to investigate it further anyway. So, you just learn to deal with it yourself. [5]” Conversations like this leave the patients feeling discouraged, uncertain, and less likely to advocate for their rights.

Cardiovascular Disease

Female patients have also discussed how there are more barriers to a diagnosis and how they also feel like there's a lack of understanding in the medical field regarding women's health Even while exhibiting the same symptoms as men for CVD ( Cardiovascular disease) women's symptoms are considered as atypical (unusual or not normal). As a result, women are less likely to be referred for a diagnostic test and are misdiagnosed or receive delayed diagnosis. This raises a lot of concerns as heart disease is the leading cause of death for women. As of 2021, 310,661 women died of heart disease and currently, 60 million women in the US live with a heart condition [6].

Moving Forward

To address these disparities, there needs to be an increase in regulation, training, and awareness to ensure that gender bias does not impact female patients. Firstly, we need to address patient and medical staff communications, specifically when it is about evaluating and diagnosing patients. Current procedures require students to ask non-specific questions while conducting evaluation which causes them to rely on their biases [9]. Increased research studies conducted on women will create more precise diagnoses and treatment plans. Additionally, it will create a better understanding of how symptoms and recovery will differ for women. Research can also help with how the curriculum and training are shaped which would directly impact the care patients will receive. Gender bias can impact how women health professionals are treated. Hence, the concerns they bring up can be undermined and this will also impact the treatments patients receive.

Conclusion

Overall, in order to create change and ensure that female patients receive the treatment that they deserve. It is important to raise awareness about these concerns and create change and the way medical treatment diagnosis and training occurs. Through advocacy, awareness, and research we can ensure that all patients receive the care they deserve.

Sources : 

1. Skvortsova A;Meeuwis SH;Vos RC;Vos HMM;van Middendorp H;Veldhuijzen DS;Evers AWM; “Implicit Gender Bias in the Diagnosis and Treatment of Type 2 Diabetes: A Randomized Online Study.” Diabetic Medicine : A Journal of the British Diabetic Association, U.S. National Library of Medicine, pubmed.ncbi.nlm.nih.gov/36919798/. 

2. Sex Bias in Pain Management Decisions, www.pnas.org/doi/10.1073/pnas.2401331121. 

3. “Women and Pain: Disparities in Experience and Treatment.” Harvard Health, 9 Oct. 2017, www.health.harvard.edu/blog/women-and-pain-disparities-in-experience-and-treatment-2017100912562. 

4. Clouser, Gillian. “Oh, the Aches and Pains.” Yale School of Medicine, Yale School of Medicine, 24 Jan. 2022, medicine.yale.edu/news-article/oh-the-aches-and-pains/.

5. Merone, Lea, et al. “‘I Just Want to Feel Safe Going to a Doctor’: Experiences of Female Patients with Chronic Conditions in Australia.” Women’s Health Reports (New Rochelle, N.Y.), U.S. National Library of Medicine, 22 Dec. 2022, pmc.ncbi.nlm.nih.gov/articles/PMC9811844/#s012.

6. “About Women and Heart Disease.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, www.cdc.gov/heart-disease/about/women-and-heart-disease.html. 

7. Author links open overlay panelHeather M. Johnson 1, et al. “Addressing the Bias in Cardiovascular Care: Missed & Delayed Diagnosis of Cardiovascular Disease in Women.” American Journal of Preventive Cardiology, Elsevier, 30 Nov. 2021, www.sciencedirect.com/science/article/pii/S2666667721001549?ref=pdf_download&fr=RR-2&rr=8e8607bcb9bdefa5.

8. “Changing the Way We View Women’s Heart Attack Symptoms.” www.Heart.Org, 24 Jan. 2023, www.heart.org/en/news/2020/03/06/changing-the-way-we-view-womens-heart-attack-symptoms

9. Paulsen, Emily, and Emily Paulsen. “Recognizing, Addressing Unintended Gender Bias in Patient Care.” Duke Health Referring Physicians, physicians.dukehealth.org/articles/recognizing-addressing-unintended-gender-bias-patient-care.