The Difference Blog by Dan4th ([info]differenceblog) wrote,
@ 2008-03-12 08:49:00
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Entry tags:arthritis, health, health care, health care workers, knee, osteoarthritis, physician visits, sexism, surgery

Physician Bias
Borkhoff et al (2008) sent two standardized (scripted) patients to visit 38 family doctors and 29 orthopedic surgeons within a 3 hour drive of Toronto, ON. The patients were scripted to have identical symptoms and circumstances related to osteoarthritis. However, the male patient had arthroplasty recommended 67% of the time, compared to only 33% recommendations for the female patient. Borkhoff concludes that the doctors may be biased, tending to treat women's complaints "less seriously."

This tendency to assume women are exaggerating is consistent with rheumatoid arthritis treatment studies examined last May (5/22/07). It may also explain why other studies find that women are far more incapacitated when they finally do present for surgery (9/26/06).


This definitely looks like a down side to the tendency of women to go to the doctor more often. Honestly, I can't tell you whether my medical concerns have been taken more seriously since transition. Doctors and transsexuals can have a very adversarial relationship as it is. I don't think I can say I've ever been treated like a man by a doctor. Hell, I still get called "miss" about half the time in the doctor's office, which I expect is pretty confusing to the other people waiting, what with my beard. I try to be reasonable and cooperative, but educating my doctors gets tiring.

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[info]furikku
2008-03-12 01:35 pm UTC (link)
Hell, I still get called "miss" about half the time in the doctor's office, which I expect is pretty confusing to the other people waiting, what with my beard.

...the hell? You'd figure at that point, something would kick in somewhere and say, "OK, man now. Masculine terms."

I don't have any real comment on the study; I rarely go to the doctor, and when I do I usually find myself taken fairly seriously. Maybe that should be "so when I do."

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[info]differenceblog
2008-03-12 01:47 pm UTC (link)
Over the past 5 years (since transition) I've probably averaged 3-4 doctors visits a year. I'd say about half of those were through the OB/GYN department. So I cut them a little slack.

My health plan is awesome because I can change my gender marker through the patient information website, BUT, it's a waste of my time to do so, because every time I go in for a pap smear they change it back, because they can't bill pap smears for a man. *chuckles* Since I kept my cervix in my recent hysterectomy, I'll still be getting pap smears for the foreseeable future. I've essentially given up.

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[info]furikku
2008-03-12 01:49 pm UTC (link)
Wow, yeah, I can see where that would cause more than a little confusion there.

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[info]planetgal471
2008-03-12 01:52 pm UTC (link)
Urgh, thanks for the warning. I'm visiting an orthopedic surgeon in about a month. Nice to know I better start with the attitude that he doesn't believe me. *fumes*

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[info]differenceblog
2008-03-12 01:55 pm UTC (link)
:( Good luck!

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[info]astrogeek01
2008-03-12 02:00 pm UTC (link)
I generally assume the doctor doesn't believe me. At least, until I found one that actually did.

I wonder if part of what makes women go to the doctor more often, is that we have to go more often to make our symptoms be taken seriously? I mean, if they listened the first time, maybe we wouldn't have to go back?

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[info]hrafn
2008-03-12 02:11 pm UTC (link)
if they listened the first time, maybe we wouldn't have to go back?

Based on what I've heard from other women (at least regarding gyn issues), yes, it does seem extraordinary to find a doctor who will take complaints seriously the first time, which means multiple doctors and/or multiple years before an appropriate treatment is found or, sometimes, even considered.

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[info]differenceblog
2008-03-12 02:14 pm UTC (link)
Well, that makes me feel a little better about the 4 visits and 6 months it took for my doctors to agree that something was going wrong

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[info]elizilla
2008-03-12 05:29 pm UTC (link)
I'm female, and I have definitely had that experience. And it's not like I go to the doctor a lot, or like I have any mysterious or difficult health issues.

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[info]catness
2008-03-13 05:03 pm UTC (link)
My medical history bears this out as well. One example (out of about 10): I have a shoulder injury I've been trying to get seen to since 1991. I've had one physical therapist and two muscular therapists agree I have serious problems, but not one single professional who's been covered by my health insurance has given me the time of day on it. If I'd stop being a hypochondriac... *shrug*

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[info]chienne_folle
2008-03-12 03:22 pm UTC (link)
My husband is always trying to get me to go to the doctor when I'm sick, and I keep telling him that doctors don't take women seriously unless we're REALLY sick. I was feeling bad for a week but didn't go to the doctor until my temp hit 101. He diagnosed me with a kidney infection and put me on the antibiotics I needed.

It truly sucks that women have to have a high fever (or some other medical equivalent) before we'll be taken seriously.

I'm going to forward your post to my husband, so he can see that I'm not making this crap up.

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[info]differenceblog
2008-03-12 03:39 pm UTC (link)
*chuckles* being used as leverage in an ongoing debate amuses and flatters me.

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[info]hrafn
2008-03-13 03:10 pm UTC (link)
Send your husband to any LJ group or online forum organized for women to talk about a particular malady (like the LJ endometriosis group, which I am most familiar with). The number of years it takes for many women to be treated properly is just appalling, and this is for chronic, life-impairing conditions. I feel like I lucked out in a big way in how quickly I was diagnosed and treated (7 months). Ooooh, it just burns me up how dismissive so many doctors are.

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[info]catness
2008-03-13 05:13 pm UTC (link)
I don't think I can say I've ever been treated like a man by a doctor. Hell, I still get called "miss" about half the time in the doctor's office, which I expect is pretty confusing to the other people waiting, what with my beard. I try to be reasonable and cooperative, but educating my doctors gets tiring.

One of my most frustrating EMT calls ever was dealing with a per diem partner and with hospital staff when we had a trans patient. My partner was outraged that she had to hear about the patient's "sex life" during the call, and the receiving hospital couldn't wrap their brains around social security number and gender not matching. I had to not punch my partner while I explained that she needed to know about a person's transgender status in order to understand possible medical ramifications, and I had to browbeat the hell out of the triage staff so they'd accept the patient into the facility without making her produce documentation with her previously legal name.

Arrrgh. People make me crazy.

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