Doctors Really Don’t Believe Women

I recently read a heart-wrenching series of reports on doctors not believing women.  I thought this sort of value judgment was outmoded, finding it hard to believe in this century and in this country. I have had at least a few experiences within the last year of patients who I sent back to the primary care physicians who referred them to me.  I simply felt that although the primary physicians had in every case told the patient it was “all in your head” and sent them to me for care, I had found signs indicative of physical illness and wanted them to have a further workup.

In each case, I turned out to be correct, and there was a medical illness that would have been inappropriate for monitoring by a psychiatrist. I figured the primary physicians were a tad overworked, as most primary physicians are.  I didn’t much worry any further. It occurred to me that every single patient with whom this has happened that I can now remember was female. There really are studies.  This is a real phenomenon.

I have known for a long time that it was difficult enough for women to achieve equality before the law.  It has never been crystal-clear how minds get opened.  How prejudices that may have been lifelong can be gently slid into human-loving open-mindedness. There is LOTS of documentation that this is a real phenomenon.  The question is what can be done to prevent it. I have told the mentally ill who visit a primary physician to bring a family member to advocate for them.  It seems, subjectively, to help, although I have not exactly done a double-blind placebo-controlled trial. It seems amazingly retrograde for me to tell women to go to a doctor with an accompanying responsible male.  It seems like an admonition from the days when a doctor needed to have a female doll on his desk so the woman could show him where the pain was on the doll, without letting him touch her body.

Doctors need to take women seriously.  I suppose they might respond to the threat of going elsewhere, for financial motivations seem to be extraordinarily important for a great deal of things.  Lots of individual practices and especially multi-doctor clinics still speak of “capitation,” which is a sort of head count of people served. The doctor gets paid for the number of patients seen, not for what each service entails. You can always tell a doctor who doesn’t listen that his “capitation” rate is about to go down by one. This is not terribly comfortable as cattle are counted by their heads, also. Perhaps the biggest ray of hope comes from the increasing number of women practicing medicine.  I remember a few years ago when the number of women in entering classes in American schools of medicine exceeded 50%, I felt certain that was a good thing, even if the “feminization” of professions has generally been accompanied with lower salaries and less social prestige for said professions.

Never give up, dear sisters, and never surrender. With people fighting to get more girls into “STEM” (Science, Technology, Engineering, and Math) and more similar issues than I can count, there is no end in the near future to helping females become full human beings in the minds of all.