When Doctors Downplay Women’s Health Concerns

August 16, 2018

“Well, you look like you’re doing great,” my primary care physician cheerfully informed me.

I stared at her from the examination table in disbelief. I had just told her that I wasn’t enjoying being with my children and was having trouble doing what needed to be done at work and at home. As a health journalist, I had interviewed dozens of physicians and psychologists. I knew that being unable to live one’s life was the big red flag signaling it was time to get help.

I was asking for help.

But my doctor was under the impression I didn’t need it. “I don’t think you’re at the point where medication is an option, and anyway, it can be addictive. Keep exercising and doing yoga, and maybe consider meditating,” she said with a tight smile. “Try to get some more sleep.”

I had just told her these very steps weren’t helping. And anxiety was keeping me from falling asleep and getting restful sleep. “But …” I began.

She quickly interjected. “If you’re still having trouble a few months from now, come back and see me again. O.K.?”

 I nodded numbly. My physician was just like me: A relatively young, educated mother of small children with plenty on her plate. And she had an M.D. after her name. Wouldn’t she know if I were truly in need of treatment?

It took several months for me to summon the courage to see another health professional — this time, a cognitive behavioral therapist who was horrified by my experience with my doctor (who, for the record, is no longer my doctor) and told me there was a lot we could try to help me start feeling better.

Therapy worked. My anxiety decreased immensely in just a few months, freeing up mental space for bigger questions. And I began to wonder just how common it was for women to have their health concerns downplayed or dismissed by a physician.

As it turns out, very. “It’s a huge issue in medicine,” says Dr. Tia Powell, a bioethicist and a professor of clinical epidemiology and population health at Albert Einstein College of Medicine in New York. Health care providers may have implicit biases that affect the way women are heard, understood and treated, she said. “Medical schools and professional guidelines are starting to address this problem, but there’s still much to be done.”

Dr. Powell, who is also the director of the Montefiore Einstein Center for Bioethics, speaks from experience: “A while back, I lost 10 pounds over a couple months, so I went to my doctor and told him I thought it was a sign I was having a recurrence of an old illness. He gave me a few reasons he disagreed and added, “Plus you’ve been on a diet.” That struck her as odd — she had never said this, and doubted her doctor would have made the same assumption about a male patient. A set of tests with a new physician confirmed that Dr. Powell was correct about the recurrence of a previous illness, for which she was immediately treated.

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