Women are 33% more likely to see a doctor than men; but they are less likely to be taken seriously by doctors. For example:
- Women wait 29% longer than men to be seen by an ER for a possible heart attack, when presenting with chest pain;
- Women with acute abdominal pain are up to 25% less likely to be treated with powerful pain medications than men;
- Women experiencing symptoms of heart disease are more likely to be diagnosed with a psychiatric condition than heart disease—essentially being told their symptoms are all in their head.
The consequences of women being ignored by doctors are severe. Between 40,000-80,000 people in the US die each year from misdiagnosis alone; and women are more likely to be misdiagnosed. But also of grave concern is that women’s medical concerns are far more likely to be downplayed than those of men.
This is called medical gaslighting, or “the experience of having a medical concern dismissed or arbitrarily attributed to a psychological or neutral cause by a healthcare provider”. The onus is often put on women to avoid this gaslighting. They are told to “be a better advocate” for themselves, or “bring an additional advocate” to appointments. But an effective solution must be traced back to the source. And in this case the source is medical education.
Sexism in the medical field
Women are also told to avoid medical gaslighting by taking copious notes and seeking second, third, and fourth opinions on medical concerns. But these steps do not tackle the source of medical gaslighting, merely the symptoms, and not everyone can or will advocate for themselves in this way.
Sadly, women experience multiple forms of discrimination in the medical field, beyond the gaslighting experienced by patients. Women medical students and practitioners are typically not given the same respect within the field as their male counterparts, and they are far more likely to report having experienced harassment than male doctors. Women are also left out of medical research, both as subjects and authors. With discrimination so firmly ingrained within the medical field, the best solution to ending gaslighting (as well as other forms of discrimination in the health system) lies in medical education.
Integrating the solution into medical education
Personal advocacy is a modular intervention—each patient impacted takes on their own case, in an effort to achieve the desired outcome of equitable treatment. If medical gaslighting is going to end, it needs an integrated solution that stops it at the source. No amount of personal advocacy is going to completely wipe out this problem until it’s addressed at its roots: medical training.
Further education on women’s health concerns and needs, and the differences between those of men, should be integrated into medical education. Offering education around differences will result in providers that are better trained to understand what they may encounter and should pay attention to when treating women. Additionally, conducting a greater amount of medical research with women as subjects, rather than simply focusing on men and projecting their results onto women, can support education on women’s health concerns and their differential responses to treatment. These steps support the idea of integration: schools should take a proactive effort to research and teach women’s health concerns to prevent and eliminate sexism in care delivery.
While advocacy is a powerful tool, one-off instances of addressing sexism in medical care are not the right approach to solving a system-wide problem. Delivering equitable care across patient populations can’t, and shouldn’t, be left up to individuals to tackle. Instead, medical schools must take a more proactive, integrative approach to sexism in medical care so that providers nationwide know how to effectively care for women without diminishing their health concerns.
