13 ms·

How gender bias affects healthcare

26 points by kunkurus 8y ago

PunchTornado 8y ago
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://bmjopen.bmj.com/content/3/8/e003320 http://news.bbc.co.uk/1/hi/health/8588686.stm 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..
- SiempreViernes 8y ago
  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?
  - PunchTornado 8y ago
    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.
  - belorn 8y ago
    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.
- matthewmacleod 8y ago
  Maybe get a better GP? Seriously, I've never encountered this attitude. Doctors seem to be generally fairly clinical and professional.
  - clojurestan 8y ago
    Young man here, happens to me all the time
  - alibarber 8y ago
    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.
  - whattheasdf 8y ago
    You assume that that is not only an option, that it is easy to do so, and that changing GP will make a difference when you are in a monopolistic system like a government captured and controlled healthcare where there is little to approaching zero incentive to differentiate and be exceptional. I frequently find myself confronted with the reality that most people don't seem to be able to fully refactor their thinking about things. They are unable to fully realize and consider the consequences and impacts of their actions on all aspects of the system they are proposing massive changes too. What's even more baffling is that this mentality is not only seemingly extremely well represented in the tech community, but that it can exist in the tech community at all without even the slightest pause about the impact of massive changes and zero appreciation for reflexive unintended (which really should be called unrealized) consequences. Another great example of this is the socialist/communist/marxist/progressive/liberal types' apparent inherently inability to comprehend that the policies and actions they advance and support will have equal and opposite reaction. There is so frequently today this assumption that "all other things will remain equal", which is absolutely never the case in a system, let alone a complex one.
- 23443463455 8y ago
  df
aristocles 8y ago
Women are on average more neurotic than men, therefore physicians will be more skeptical of their claims; psychosomatic symptoms are more common for females.
- whichdan 8y ago
  Let's not perpetuate more of the bias and sexism that the article is talking about.
  - mrybczyn 8y ago
    Sex differences in the genetic sense exist, and are founded on physics, chemistry and biology. Let's not hide from them either, veiled behind ideological double-speak. Balance.
    - Spivak 8y ago
      Not sexist: "Women on average have a higher rate of mood disorders." Sexist: "I'm going to be more skeptical of this particular woman's experience because she's a woman and probably is just hysterical."
      - yasp 8y ago
        Suppose for the sake of argument that on average women have higher rates of thinking something is physically wrong with them when there isn't. Is it not rational for doctors to take a Bayesian approach and weight their diagnoses accordingly?
        Retric 8y ago
        Bayesian reasoning is a terrible fit for healthcare because it ignores risks. Suppose 99% of the time a set of symptoms is harmless and 1% of the time it's deadly. A 1% risk of death is extremely high and needs to be taken seriously even if ignoring it would be correct 99% of the time.
tehwebguy 8y ago
> ...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.
- Spooky23 8y ago
  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".
- JackCh 8y ago
  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.
- Mirioron 8y ago
  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.
epmaybe 8y ago
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.
rdlecler1 8y ago
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.

26 points by kunkurus 8y ago

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://bmjopen.bmj.com/content/3/8/e003320 http://news.bbc.co.uk/1/hi/health/8588686.stm 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..

SiempreViernes 8y ago
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?
- PunchTornado 8y ago
  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.
- belorn 8y ago
  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.
matthewmacleod 8y ago
Maybe get a better GP? Seriously, I've never encountered this attitude. Doctors seem to be generally fairly clinical and professional.
- clojurestan 8y ago
  Young man here, happens to me all the time
- alibarber 8y ago
  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.
- whattheasdf 8y ago
  You assume that that is not only an option, that it is easy to do so, and that changing GP will make a difference when you are in a monopolistic system like a government captured and controlled healthcare where there is little to approaching zero incentive to differentiate and be exceptional. I frequently find myself confronted with the reality that most people don't seem to be able to fully refactor their thinking about things. They are unable to fully realize and consider the consequences and impacts of their actions on all aspects of the system they are proposing massive changes too. What's even more baffling is that this mentality is not only seemingly extremely well represented in the tech community, but that it can exist in the tech community at all without even the slightest pause about the impact of massive changes and zero appreciation for reflexive unintended (which really should be called unrealized) consequences. Another great example of this is the socialist/communist/marxist/progressive/liberal types' apparent inherently inability to comprehend that the policies and actions they advance and support will have equal and opposite reaction. There is so frequently today this assumption that "all other things will remain equal", which is absolutely never the case in a system, let alone a complex one.
23443463455 8y ago
df

aristocles 8y ago

Women are on average more neurotic than men, therefore physicians will be more skeptical of their claims; psychosomatic symptoms are more common for females.

whichdan 8y ago
Let's not perpetuate more of the bias and sexism that the article is talking about.
- mrybczyn 8y ago
  Sex differences in the genetic sense exist, and are founded on physics, chemistry and biology. Let's not hide from them either, veiled behind ideological double-speak. Balance.
  - Spivak 8y ago
    Not sexist: "Women on average have a higher rate of mood disorders." Sexist: "I'm going to be more skeptical of this particular woman's experience because she's a woman and probably is just hysterical."
    - yasp 8y ago
      Suppose for the sake of argument that on average women have higher rates of thinking something is physically wrong with them when there isn't. Is it not rational for doctors to take a Bayesian approach and weight their diagnoses accordingly?
      - Retric 8y ago
        Bayesian reasoning is a terrible fit for healthcare because it ignores risks. Suppose 99% of the time a set of symptoms is harmless and 1% of the time it's deadly. A 1% risk of death is extremely high and needs to be taken seriously even if ignoring it would be correct 99% of the time.

tehwebguy 8y ago

> ...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.

Spooky23 8y ago
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".
JackCh 8y ago
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.
Mirioron 8y ago
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.

epmaybe 8y ago

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.

rdlecler1 8y ago

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.