Article
Introduction
Disparities in healthcare do not just concern access to care, it concerns access to quality care. Patients may find their treatment affected by social, cultural, financial, environmental, and other factors that don’t include their actual ailments. Healthcare has not been immune to social issues in the world. In a field that treats people of various types and needs, it can be imagined that there are unique challenges and difficulties for patients and physicians that differ from one another in physicality and perception. As the world becomes more aware of its systemic and societal flaws, there are patterns in healthcare equity and quality that serve to prove how divided and discriminated people are. By being aware of these phenomena and challenging one’s own biases, the health of a healthcare system can be as optimal as it aspires to achieve for its patients.
Sexism: Women
Women are a widely known minority to face gaslighting, misdiagnosis, lack of research and representation in clinical trials, little bodily autonomy in procedures, and misinformation. It took over 20 years for the FDA to roll back 8 drugs marketed for widespread use after the GAO reexamined them and their serious health risks to female patients. A lack of funding for women’s health issues and a majority of male specimens being tested in clinical trials contribute to a knowledge disparity and persist the suffering of female patients. While 70% of chronic pain patients are women, male mice and human men make up 80% of test subjects in pain studies. Despite common perception, lung cancer is the leading cause of cancerous deaths for women, with fatalities amassing more than breast, ovarian, and uterine cancer combined. The number one leading cause of death for women in the United States is heart disease, yet knowledge of symptoms and signs have been based mainly on the male body. On average, women wait more than an hour in the ER compared to men at 49 minutes. Any number of extra minutes means more lives risked. Although nearly 1 in 10 women worldwide has endometriosis, it takes up to 10 years to get diagnosed. Whether it is a priority of research, the amount empathy and attentiveness a patient receives when seeing a doctor, or the ability to feel comfortable and that a patient and their concerns matter, one’s sex should not dictate their treatment.
Racism
According to the Association of American Medical Colleges, “Half of white medical trainees believe such myths as black people have thicker skin or less sensitive nerve endings than white people”. Racism and socioeconomic class often tie together when it comes to health outcomes of patients who still end up seeing a physician. Other studies have shown that medical students and practitioners have misconceptions about black patients’ pain tolerance, which corresponds to more misdiagnosis and mistreatment. 22% of African American patients are less likely to receive pain medication than their white counterparts. The mortality rates of Black and Native American women for pregnancy-related causes are 3 times more than white women. Wait times and priority of patients of color also hold inequities. In a study that was released in JAMA Internal Medicine, it was found that Black, Brown, unemployed, and patients with less education waited 25% longer to see a healthcare professional. White patients waited 80 minutes to see a physician, Latinos waited 105, Blacks had waited 99, and other nonwhites waited 83 minutes.
Beyond bias and discrimination in medical practice, the adequacy of diversity in physician training and inclusive medical curricula is lacking. In a U.S. survey, 47% of dermatologists and dermatology residents reported they felt their training lacked adequacy in the education of skin conditions of black patients. Lack of diverse inclusion in textbooks and curricula widen the knowledge gaps. A wide study that analyzed general medical textbooks found little diversity in skin types, with only 4.5% of images showing dark skin. The 5-year melanoma (skin cancer) survival rate is 92.9% for whites compared to 74.1% for blacks. Attitudes towards patients who have every right to feel misunderstood seal more barriers to proper treatment. A report from The Journal of Ethnic and Racial Studies states, “When doctors and nurses were given an anonymous survey asking them to explain racial inequalities in healthcare, most providers saw Black patients as “passive” and unintelligent, and blamed them for not making pointed care requests of their providers.” There is an overwhelming and alarming amount of evidence that racism in healthcare exists and continues to take lives. Racism is an illness in the medical field that needs to be checked up on.
Physicians
In the United States, patient satisfaction scores affect how physicians are paid. Since this revolves around patients’ views and feedback, it inherently discriminates against women and physicians of color. This is also one factor that contributes to physician pay gaps between genders and ethnicities, even when accounting for specialty and hours worked. According to Harvard Business Review, “One national study of academic physicians in 24 public medical schools found that female physicians make about 10% less than their male counterparts at all academic ranks, even after adjusting for specialty, hours worked, and other variables. Medscape’s 2019 Physician Compensation Report finds even greater disparities, with full-time male primary care and specialist doctors earning 25% and 33% more, respectively, than their female counterparts.” The Association of American Medical Colleges found in 2014 that despite an even distribution of medical students and residents, females make up only 38% of faculty, 16% of deans, and 21% of full professors in academic institutions. Women and minorities who carry the extra challenges and obstacles in STEM include aspiring physicians. This trickles down to harassment and discouragement when they try to pursue their goals or when they’re discredited and not acknowledged. In the United States, white male doctors earn 35% more than their black male peers, still when accounting for factors like specialty, experience, and work hours. The pay gap widens for white women and other female physicians and doctors of color. Numerous stories of female doctors and doctors of color not being recognized as physicians or healthcare workers indicate the long-standing stereotype that a practitioner is, and should be, white and male. These hostile norms and attitudes towards diverse doctors exist anywhere where there are similarly outdated ideals and stigmas in their culture. Social issues that exist anywhere infiltrate the most well-meaning institutions and healthcare cannot be negated as one that needs improvement, for both patient and practitioner.
Conclusion
Despite how elaborate one article can be, it is sad that there are more issues and indecent experiences that people have. This contributes to their skepticism and apprehension towards seeking medical treatment in the future, and of course, the lack of quality treatment offered. Even if one does not witness or experience these things, denying their existence adds to the problem. While it is unfortunate that such issues exist in a field that is supposed to help peoples’ health and vitality, it is only more important that there is awareness of these types of incidents and how common they are. Hopefully, with more education and empathy, physicians and patients alike can be healthier and happier in their lives wherever they go, especially if it’s in the doctor’s office.
Sources
https://www.drugwatch.com/featured/fda-let-women-down/
https://healthcare.utah.edu/the-scope/shows.php?shows=0_ziut6aix
https://www.theatlantic.com/health/archive/2015/10/emergency-room-wait-times-sexism/410515/
https://www.aamc.org/news-insights/how-we-fail-black-patients-pain
https://www.tandfonline.com/doi/full/10.1080/01419870903501970?scroll=top&needAccess=true
https://www.jaad.org/article/S0190-9622(20)30700-3/abstract
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3742002/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3540621/
https://www.medicaleconomics.com/view/how-patient-satisfaction-scores-are-changing-medicine