Women’s care

The American Medical Association’s recent report of how well and thoroughly women are cared for by phyiscians is the kind of diagnosis for which doctors take patients into their private offices. “I’m afraid it’s bad news,” a doctor might say, “sex bias is widespread and could be malignant. We’ll have to operate.”

Women, the report presented to the AMA’s House of Delegates says, receive more overall care by physicians than do men, but men are significantly more likely to receive greater medical attention for serious problems. Research continues to favor studies of men or problems more likely to occur in men, to a dangerous level of exclusion for women, according to the report, “Gender Disparities in Clinical Decision-Making.”

What this means practically is that, under similar conditions, a man is more likely than a woman to receive a kidney transplant and has a better chance of receiving optimum cardiac care. Women stand a lesser chance of having lung cancer detected because doctors conduct more tests on men, the study concludes, even when male and female test subjects have similar histories of smoking and medical problems.

Doctors more frequently decide that women’s physical problems are emotional or the result of anxiety. This, the report states, “Perceiving men’s utilization practices as normal and attributing overanxiousness to women’s concerns about their health may be doing a disservice to both sexes,” the report states. Men, it seems, often resist seeking care until a health problem has become acute.

The report does not confirm a connection between what it calls “gender bias” and “gender disparities in the delivery of health care,” but it does suggest that the differences in care could be attributable to the perception than men’s value to society is greater than women’s. Men more often are treated by more efficient procedures such as a kidney transplant rather than dialysis or coronary bypass surgery rather than antianginal drug therapy because their time and their worth to their families is considered more critical than women’s. Basing care on these assumptions, the report correctly notes, is inexcusable.

Another reason for differences in treatment may begin at the research level. Men are vastly more often the subject of research even though a government task force in 1985 reported that a lack of research data on women limited physicians’ understanding of women’s health needs. The results of research on men, the AMA report states, “are often generalized to women without any real evidence of effectiveness or safety for women.”

Biological differences between the sexes explains some of the differences in research and treatment, but not nearly all. To cure the disparity, the AMA recommends that more research in women’s health be pursued, that women be given greater opportunity for promotion in the medical community, and that physicians examine their practices and attitudes.

This cure-thyself attitude may bring about gradual change, at best, but meanwhile leaves women in the unhealthy position of wondering what level of care they are receiving. Their concern is justified and should cause the AMA to seek a more active methods for change.