It can be scary to navigate medical symptoms alone. When you arrive at your doctor鈥檚
office, you hope they can answer questions regarding your overall health and wellbeing.
Unfortunately, as noted below, being called 鈥渟ensitive鈥� or 鈥渄ramatic鈥� is common for
women, especially women of color. A labeled this experience as 鈥渕edical gaslighting鈥濃�攚here doctors dismiss or minimize
complaints and concerns. The danger that follows can be an unnecessary delay in treatment
for those who might need it. But why does this happen? , a physician at , shares more details on the prevalence of this issue and what can be done to address
it.
鈥淭here are probably a handful of reasons. A big one is systemic misogyny in medicine and the belief that women, or folks who are not the default, are maybe more 鈥榮ensitive鈥� to pain. But there鈥檚 also the reality that a lot of women express their pain in a way that may be seen as 鈥榙ramatic鈥� as compared to men by physicians who are not used to hearing from patients in this way. There is a sense that when we are more emotional about it, we are exaggerating or playing it up to some extent.鈥�
鈥淚 don鈥檛 want women to have to downplay their symptoms, concerns, or pain, but sometimes we have to present it in a way that might come across more palatable for someone who might not be used to the way we express things. I often ask patients to keep a log or a journal noting what symptoms they were experiencing and on which date and time. I do this with a lot of patients for any kind of condition that we鈥檙e trying to identify the cause of. This is a way we, as physicians, can get at the root of something. It鈥檚 helpful to us in identifying root causes, but it's also a way of expressing what鈥檚 happening in a very neutral tone so that hopefully patients are taken seriously.鈥�
鈥淭here is systemic racism in medicine in America. When you think about, for example, in the field of gynecology, Dr. J. Marion Sims for a longtime was considered the father of medical gynecology. He created procedures and surgeries and did so by performing research on slaves, whom he purchased, with no anesthesia. The theory was that Black people did not feel pain or that their tolerance for pain was greater. So much of the field of medicine for women is rooted in this baseline of racism. There has been a long running identification of this.
Even as recently as 2016, they did a survey of laypeople, resident physicians, and medical students and many of them held some belief that African American people felt less pain, or that their skin was thicker in some way so it was harder to puncture for procedures. Just obvious, grossly untrue facts, that not just laypeople, but people who were in training or training others still held onto. Some of the work to right this wrong is working on education at all levels of medicine and reinforcing that these beliefs are false.鈥�
鈥淎 lot of it is advocating for our patients when we see people perpetuating it, which I think is hard in a very hierarchical system like medicine. A study came out just recently that Black patients do better when they have Black doctors. Representation of marginalized people in medicine obviously makes it easier to be heard and for people to take their symptoms and pain seriously. Some of it is on us in the medical and education system to make sure we鈥檙e educating a true representation of what the population looks like.鈥�
鈥淲hen I delivered my baby, I was still a resident and had been delivering other people鈥檚 babies. Things I had said before were said back to me in labor, and I said to myself, 鈥榳hat would possess you to let that come out of your mouth?鈥�. I think at one point, because my daughter came too quickly and I couldn鈥檛 receive an epidural as part of my birth plan, they told me, 鈥榯here鈥檚 just no time.鈥� I said that I didn't think I could do it and they said, 鈥榖ut you鈥檙e doing it!鈥�.
What I was really feeling was scared, but what it felt like they had said back to me was 鈥榯ough鈥攚e鈥檙e doing this now.鈥� I鈥檓 certain I鈥檝e said the same thing to someone in labor, but at that moment, it wasn鈥檛 so reassuring.
Sometimes we think we鈥檙e being really supportive, but we鈥檙e not actually hearing what patients are telling us, which is 鈥榯his is scary, and I鈥檓 really worried about this.鈥� That can be really hard to express, especially in the midst of something as dramatic as labor.
It really changed the way I try to approach people. I am now in the office and no longer in the delivery room, but the way I acknowledge people鈥檚 concerns is different. I try to really acknowledge what鈥檚 happening to them鈥攖heir pain, their concern, their worry. I think that ultimately makes a better patient/doctor dynamic and, hopefully, patients feel more heard and we can identify things more correctly to treat them more appropriately.
As women, we鈥檙e more likely to be told that it鈥檚 in our head. I think the acknowledgment from the physician of 鈥業 don鈥檛 know the cause of this, but we鈥檙e going to work to find the cause together,鈥� and asking if there are specific things they鈥檙e worried it might be, can help rule out all of the scary stuff for the patient and us as physicians.鈥�
Established in 1899, 黑料传送门 has trained thousands of highly competent, caring physicians, health practitioners and behavioral scientists who practice a 鈥渨hole person鈥� approach to care鈥攖reating people, not just symptoms. 黑料传送门, a private, not-for-profit accredited institution of higher education, operates three campuses (黑料传送门, 黑料传送门 Georgia and 黑料传送门 South Georgia) and offers doctoral degrees in clinical psychology, educational psychology, osteopathic medicine, pharmacy, physical therapy, and school psychology. The college also offers graduate degrees in applied behavior analysis, applied positive psychology, biomedical sciences, forensic medicine, medical laboratory science, mental health counseling, physician assistant studies, and school psychology. 黑料传送门 students learn the importance of health promotion, research, education and service to the community. Through its community-based Healthcare Centers, 黑料传送门 provides care to medically underserved populations. For more information, visit pcom.edu or call 215-871-6100.
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