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Patients' pain is real, and so is medical bias

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Whenever I go to a GP, I always request a female doctor. This isn't really about personal preference, but about bias. Ever since hitting my mid-teens, I've found I have slightly better odds with a female doctor actually engaging with my concerns.

Woman talking to doctor (Credit: FatCamera via Getty Images)But that's not to say that women are magically free from bias. As this video on Twitter shows, women in the medical profession are just as capable of dismissing patients' concerns. The video, in which an American health care worker plays a character who she calls out for 'faking' a cough, prompted disability advocate Imani Barbarin to coin the hashtag #PatientsAreNotFaking. People started tweeting in droves their own personal experiences of not being believed.

The original poster did follow up on her Twitter explaining the intent of the video was humorous. But intent doesn't negate impact and as Barbarin says, when 'people get killed because of that mentality', it's probably not something medical professionals should joke about.

This issue is not limited to the US. Medical systems around the world, including Australia, are just as complicit. The report 'Brave Men and Emotional Women', which reviewed 77 different articles in medical journals internationally, found that while men were often described as 'stoic' women were perceived as 'hysterical', 'emotional' and 'malingerers'.

That women are habitual complainers when it comes to pain is, in my experience, blatantly untrue. I have a vivid memory of sitting on a train and overhearing a woman tell her friend that she was fine, she was only experiencing her 'normal pain'. Her friend, thankfully, replied that there is no such thing as 'normal pain'. But that wasn't the first time I had heard something of that ilk, or said something like it myself.

Marginalised folk are told over and over again that their pain and lives, in general, don't matter. Women who experience chronic pain are often told by doctors that their pain is not real or is just psychosomatic, and are often instead prescribed antidepressants or referred to a mental health service. It's hard for queer and trans people to find a doctor who can provide them with 'culturally competent' care.

For marginalised people, diagnosis times take longer and can sometimes lead to poorer outcomes — for example, the estimated diagnosis period for endometriosis is seven to 12 years. Patients' pain not being taken seriously also leads to poorer outcomes during childbirth and postnatal care for black and Indigenous women and increased deaths in custody for First Nations women, the cases of Naomi Williams and Ms Dhu being recent, heartbreaking examples.


"Their pain is real, and they deserve better than this."


This bias continues to be so prevalent not only because medicine is a reflection of society, but because medicine was created with cisgender white neurotypical able-bodied men as the baseline. Those underlying assumptions are still baked into medical systems and filter down to all aspects of medicine.

This can look like how the medicine women take isn't as effective or has more side effects because it was only tested on men. Or how more women, in particular black women, die of heart attacks and other cardiovascular diseases. Sometimes they weren't treated at all because the signs are different to how heart attacks present in men, or if they were treated, they are often undertreated.

While awareness of this issue has been steadily growing for years, the entire medical profession still needs to reckon with why marginalised people are routinely ignored when it comes to their health concerns. A recent report from the Medical Journal of Australia concludes that Australian medical research that specifically accounts for sex and gender in particular is lagging behind.

Advocates and allies in the medical community reiterate that it's important that doctors are taught about bias within medicine, how to appropriately treat chronic pain and how different presentations of illnesses can occur in different types of bodies. Going to seek medical help shouldn't compound marginalised people's trauma.

Marginalised people shouldn't have to advocate for themselves to the level that they do. And when they do advocate for themselves, they should be treated with respect. But for now, there are ways to navigate the system. These can include taking an ally to appointments or asking for any course of treatment or refusal of treatment to be documented. Their pain is real, and they deserve better than this.



Neve MahoneyNeve Mahoney is Assistant Editor of Eureka Street and a student at RMIT university. She has also contributed to Australian Catholics and The Big Issue.

Main image credit: FatCamera via Getty Images

Topic tags: Neve Mahoney, health



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Existing comments

Bias is a funny thing. Some might say that a male who always insists on being served by a male has a certain bias or indeed a female who always insists on a female doctor has a certain bias. Some might even say that bias exists only in the minds of those who perceive it. The big problem with bias is that it always laughs last eg the person who turns down the best service available to him/her on the basis of gender rather than quality of the service provided.

john frawley | 29 November 2019  

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