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Listen Up! Gender bias in medicine is real.

Hey Doc! panel
We discovered how to get doctors to listen to you in the Hey Doc! Are You Listening? Panel Discussion!

My whole life, I’ve dreaded going to the gynecologist. I’m willing to bet this isn’t on many people’s list of the top ten favorite ways to spend time. But year after year, I have gritted my teeth and tried to ignore the overwhelming feelings of vulnerability to go through the ritual to care for my reproductive health. We have had to learn to accept this feeling as part of the trials of being a woman, blessed with a body that can give birth.

Maybe it’s because reproductive health isn’t something men have to think about unless something malfunctions that medical science has ignored other differences in our bodies until very recently. Before the 1990s, most medical research was done exclusively with males, thinking that they make the best test subjects because they don’t have menstrual cycles and can’t get pregnant.

We’re just beginning to learn how important biological differences between sexes can influence how diseases, drugs, and therapies affect us. This lack of research into how women’s bodies respond means that conditions go undiagnosed and mistreated because our bodies react differently.

The differences in how men and women are treated in medical care don’t stop there. It impacts how doctors approach patients and their care. Women are often told their symptoms and pain are exaggerated, all in their heads, while men with the same complaints are treated for physical conditions. This bias has held on since the 18th and 19th Centuries when the most commonly diagnosed illness in women was Female Hysteria. This nebulous disorder got "unmanageable" women locked up in insane asylums.

Women are not being taken seriously by doctors when describing their symptoms in a medical system that doesn’t understand how women’s bodies react differently to illnesses and treatments. It is a mess! So, what can we do about it? We can bring together a panel of healthcare providers and talk about it.

The Badass Women of Wichita Alliance hosted the panel discussion, “Hey Doc! Are you listening?” for answers to our questions and advice on how to be heard. Our panelists were Dr. Michelle Cortez of Breathe Physical Therapy, who specializes in treatments for continence; Danielle Kauffman, APRN of HealthCore Clinic, who specializes in Family Practice; and Isobeau Trybula, MSOM,, Acupuncture and Chinese medicine specializing in migraine, digestive complaints, and gynecological health, including using acupuncture with assisted fertility techniques.

We had a fantastic discussion about some concrete actions we can take to get better service from the medical community. Here’s what we learned.

Bring notes and take notes.

It’s hard to remember everything you want to discuss with a doctor during your visit. Most doctors schedule five to 15 minutes to spend in the exam room with you. To make sure you stay focused and get your concern addressed, write down what you want to talk about and the questions you want to ask. Make note of the answers you receive and anything else you think is essential to remember better what your doctor said.

Keep track of your records.

Create a file that you can use for all your medical records. Keep a copy of all your lab results, doctors’ orders, prescription information, bills, and notes you’ve taken during medical appointments all in one place. This will be helpful when you want to refer back to something that was said, compare test results, and ensure you’re doing what you need to do to get better.

Be aware of Trauma Informed Care.

Medical services can trigger a trauma response, especially in OB-GYN exams. So, some doctor offices are putting Trauma Informed Care policies in place to create an environment of healing and recovery and consider how practices and exams can be performed without re-traumatizing the patient. Ask your doctor’s office what Trauma Informed practices they put into place.

Ask where they stand.

The way doctors think about political issues can impact the treatment options they recommend, especially as judgments about the constitutionality of refusing care based on personal beliefs are being handed down. It is perfectly appropriate to discuss with your doctor whom they refuse to treat and treatments they refuse to recommend.

You can refuse.

You don’t have to do anything you don’t want to do during your exam. You can refuse to step on the scale and be weighed unless there’s a specific reason tied to your treatment. You don’t have to submit to a manual breast exam, though self-exams are a good idea, and mammograms mustn’t be skipped. You can tell your doctor you’d rather they use plastic speculums or place them yourself. If a specific test during your exam is super stressful for you, talk to your doctor about it and find out what your options are.

You don’t have to do anything your doctor recommends, either. This includes taking medications, treatments, and tests you don’t want. It’s a good idea to ask what will happen if you don’t do what they recommend before taking action. Don’t stop any treatments or put off starting treatments without talking to your doctor first.

Ask for what you want.

If you have questions about a test or treatment, talk to your doctor. If they refuse to prescribe what you’ve requested, insist that they note why they’ve refused in your chart. Being required by law to make this note can be enough to convince them to try what you’ve asked.

It’s not all in your head.

Blaming your age, sex, weight, or mental state to explain away your symptoms is dangerous. Some symptoms are more common with age, but does that mean they can’t be treated? When given these reasons for a dead end in your medical care, ask the doc, “What if I wasn’t old, fat, or a woman? What would we try next?”

Pain is very real. It is exhausting and stressful, which may come off as being mentally unbalanced to the unformed. There may be alternatives to medication for many types of pain, including migraines. Partner with your medical practitioner to experiment and find the best solutions for you that go beyond masking symptoms.

Don’t be afraid to change doctors.

If you don’t feel the relationship with your medical professional is a partnership, it’s time to move on. If you have a doctor who refuses to dig deeper, won’t listen, or doesn’t seem to respect what you’re saying about your body, it’s hard to trust that they are looking out for your best interests. You have to trust the doctor enough to tell them the whole story about your health so they have all the information they need to make a recommendation. Sometimes we don’t click with another person, which is also a valid reason to find someone new.

Ask for recommendations.

The best way to find a new doctor is by asking people whom they like. You can ask a doctor you feel comfortable with to recommend someone they know or have worked with. Friends, especially those with similar health issues, are a fantastic way to vet doctors. Believe it or not, hair stylists are usually great people to ask about referrals. They talk to people all day, every day, and can make better recommendations than a professional concierge.

Be your own best advocate.

Most importantly, we must learn to speak up for ourselves and the little ones we are responsible for keeping well. Take charge of your course of treatment and do a little research or get another opinion when things don’t sound quite right.

Advances in women’s health interestingly coincide with other fights for women’s rights. It wasn’t until the 1960s, when the Women’s Health Movement was born, and federal policies were passed to improve health care for all women. We’re not done fighting for women’s health, and the very best place to start is with your own and making sure your voice is heard.

How can you better advocate for your health?

Headmistress Jill

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