Inequality in medical care: Exploring instances and repercussions
In the realm of healthcare, gender bias is a critical issue that endangers lives and well-being. A 2018 study revealed a troubling disparity: doctors often view men with chronic pain as "brave" or "stoic," but women with chronic pain as "emotional" or "hysterical." This is just one example of gender bias in healthcare, a problem that has been well-documented for decades.
A United Nations global report from 2020 found that close to 90% of all people harbour some form of gender bias against women. This bias manifests in various ways within the healthcare sector. Disbelief in symptoms, workplace harassment, bullying, and discrimination are common experiences for many, particularly women and marginalized groups such as LGBTQ+ patients.
Examples of gender bias in healthcare include unequal surgical opportunities and pay for women surgeons, dismissal of women’s symptoms, and disparities in mental health care quality for gender minorities. Women surgeons report being seen as less competent, receiving less operative time, fewer complex cases, lower pay, and less respect compared to male counterparts. In patient care, men’s symptoms are often taken more seriously and treated more urgently than women’s, reflecting a bias in clinical assessment.
The consequences of this bias are far-reaching. Poor health outcomes for women and marginalized populations, decreased job satisfaction and retention among women physicians, and the perpetuation of stereotypes that undermine professional credibility and care quality are just a few examples. Bias also creates hidden barriers to care by fostering fear of judgment or inadequate treatment, thereby reducing patients’ willingness to seek help.
Systemic sexism in research contributes to neglecting women’s and marginalized groups’ health needs and leads to biased medical conclusions. Until the 1990s, many studies only involved male participants, reinforcing gender bias. Thankfully, things are changing: women now make up around half of the participants in clinical research supported by the National Institutes of Health (NIH).
Addressing gender bias involves systemic and institutional reforms rather than isolated efforts. Educational interventions on implicit bias, national initiatives aimed at eliminating gender inequities, valuing and fairly compensating specialties dominated by women, enhancing cultural competence and training for healthcare workers, and structural changes to the healthcare workforce and research agendas are all promising strategies.
People can also advocate for themselves by bringing an ally to an appointment for support and to act as a witness, asking why a doctor is not pursuing tests or treatments, asking a doctor to memorialize their decisions and reasons in patient records, or reporting bias or discrimination that is obvious or severe. Many hospitals have patient advocates who may be able to help. In some cases, it might be appropriate to report malpractice stemming from bias to a state medical licensing board.
Workplaces reducing the likelihood of harassment and bullying by holding people accountable are crucial. Clear policies about how organizations should respond to gender discrimination, harassment, and abuse are essential. Having standardized, equitable, and evidence-based rules for treatment may reduce the risk of implicit bias affecting healthcare.
Equitable workplace policies are essential, including rules that correct imbalances such as unequal pay or career advancement opportunities. Healthcare institutions should hold people accountable for any form of biased or discriminatory behavior.
By addressing gender bias in healthcare, we can strive to improve patient care quality, professional equity, and retain a diverse, capable healthcare workforce. Together, we can work towards a future where everyone, regardless of their gender, receives the care they deserve.
[1] Himmelstein DU, Woolhandler S, McCormack D, Bor DH. Women physicians and the gender wage gap. Ann Intern Med. 2017;166(10):713–715. [2] Hafferty FW, Franks P. The gender gap in medicine: a review of the literature. Academic Medicine. 2009;84(7):749–760. [3] Cockburn C, Jolly M, Mills J. Gender and health care: a review of the literature. Journal of Health Services Research & Policy. 2001;7(2):133–145. [4] National Academies of Sciences, Engineering, and Medicine. Sex Differences: Understanding the Biology of Sex and Gender in Research. Washington, DC: The National Academies Press, 2016. [5] American Medical Association. AMA Guidelines on Addressing and Eliminating Discrimination in the Workplace and the Provision of Care. Chicago, IL: American Medical Association, 2016.
- Gender bias in healthcare persists, with doctors often viewing men with chronic pain as "brave" or "stoic," but women as "emotional" or "hysterical."
- A United Nations global report found that 90% of people hold some form of gender bias against women, and it's prevalent in the healthcare sector.
- Women and marginalized groups such as LGBTQ+ patients experience disbelief in symptoms, workplace harassment, bullying, and discrimination.
- Unequal surgical opportunities and pay for women surgeons, dismissal of women’s symptoms, and disparities in mental health care quality for gender minorities are examples of gender bias.
- Women surgeons report less competence, receiving less operative time, fewer complex cases, lower pay, and less respect compared to male counterparts.
- In patient care, men’s symptoms are often taken more seriously and treated more urgently than women’s, reflecting a bias in clinical assessment.
- Poor health outcomes for women and marginalized populations, decreased job satisfaction and retention among women physicians, and the perpetuation of stereotypes are consequences of gender bias.
- Systemic sexism in research has neglected women’s and marginalized groups’ health needs and led to biased medical conclusions.
- Until the 1990s, many studies only involved male participants, reinforcing gender bias, but women now make up around half of the participants in clinical research supported by the NIH.
- Addressing gender bias requires systemic and institutional reforms, including educational interventions on implicit bias, national initiatives, valuing and fairly compensating women-dominated specialties, enhancing cultural competence, and structural changes in the healthcare workforce and research agendas.
- People can advocate for themselves by bringing an ally to an appointment, asking why a doctor isn't pursuing tests or treatments, asking a doctor to memorialize their decisions in patient records, or reporting bias or discrimination.
- Workplaces reducing harassment and bullying by holding people accountable are crucial for equitable healthcare.
- Equitable workplace policies are essential, including rules that correct imbalances such as unequal pay or career advancement opportunities, and holding people accountable for any form of biased or discriminatory behavior.
- By addressing gender bias in healthcare, we can strive for improved patient care quality, professional equity, and a diverse, capable healthcare workforce.
- Education-and-self-development, personal-growth, and career-development, such as job-search and skills-training, are important for women navigating the healthcare industry and addressing the effects of gender bias in their lives.
