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Why Dont Doctors Listen to Women?

Discussion in 'General ME/CFS News' started by shrewsbury, May 18, 2010.

  1. shrewsbury

    shrewsbury member

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    Ms Magazine May 14, 2010 by Nancy Klimas 7 Comments

    [sb/if: I like how Dr Klimas slipped ME/CFS into the article. The more that this type of thing happens, of ME/CFS being a common (acurate) reference made in articles on other topics, the more quickly I think ME/CFS will move into mainstream medicine, funding and public awareness. Note that the link for CFS goes to a 2006 article Klimas wrote for MS. Also, I thought her advice on working with a new doctor might work.]

    I hear it all the time: Why dont doctors listen to women? Who would know their own bodies better? Yet time and time again, women tell their doctors how they are feeling only to have the doctors make the leap to diagnosing the women as depressed or overreacting, or give some other dismissive response. Why?

    How do we dispel the age-old myths that women are emotional, overreactive and generally unable to describe their own medical conditions? The answer is not a simple one, but its critical that we get our message acrossbecause our lives depend on it.

    Women having heart attacks often present very differently than men. We dont experience the classic arm tingling or piercing pain in the chest; sometimes a stomachache or shoulder pain are the warnings signs. If you are experiencing pain that is completely different and out of the norm for you, particularly if the pain is worse with exercise, then go to the ER and announce that you are having a heart attack. Do not be dismissed with an antacid and a wish for your well being.

    There are many examples of illnesses that are dismissed by some doctors. I care for patients with Chronic Fatigue Syndrome, and I have heard the most outrageous stories. Women encouraged by their doctors to change the color of their hair, have a makeover, find a new boyfriend or, most often, seek care elsewhere. A disabling and devastating illness is trivialized while patients are given antidepressants and anti-anxiety medications instead of proper evaluation and treatment. It is infuriating and harmful.

    If you are suffering from a chronic illness and your doctors are not responding, heres what you should do: First, make a series of appointment with an appropriate physician so that you can cover all your issues without the doctor feeling rushed or stressed by trying to deal with an overwhelming amount of information in a short amount of time. If the doctor has 7-minute appointments, use the time wisely. Visit One is a get-to-know-you; Visit Two is to deal with your sleep issues, Visit Three your headaches, etc. The doctor will be pleased you understand the time constraints and work with you. If you find you simply cannot communicate or dont trust your doctor to have your best interests in mind, find another! You have to be your best advocate. Value yourself!

    Photo courtesy of http://www.flickr.com/photos/seattlemunicipalarchives/ / CC BY 2.0
  2. Koan

    Koan Be the change.

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    Thank you!

    :hug:
  3. unity47

    unity47 unity47

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    excellent article in the magazine,and very good advice in your last paragraph.Thank you for posting,I have only just become aware of Dr.Klimas through this forum,will continue my quest for info.
  4. JT1024

    JT1024 Senior Member

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    Great post, Shrewsbury, Thanks!
  5. Woody

    Woody

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    Shewsbury

    I really don't think that women are less believed than men. I think that we are all "branded" by the label, ingnorance ... Just look what Dr. Yes is going through with his doctors. It took me (male) over 7 years to get a diagnosis along with considerable medical abuse and accusations along the way. On the other hand, my sister was diagnosed on her first visit to a specialist in less than 30 minutes! (Neither one of us has any history with psych. problems)

    So here I am 8 years later, my doctor's retired, and suddenly I'm starting over again. My Sis moved from the area 4 years ago, and last i heard wasn't too happy with her new Doc. Hope we both get lucky this time. The band plays on and someone keeps yelling encore!
  6. Woody

    Woody

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    Just wanted to add

    Thank you Dr. Klimas!:Sign Good Job: Maybe someone could send her a link, so she knows she is appreciated.

    Another thought, I wonder if the disbelief we encounter is propagated by a greater degree by male doctors?:eek:
  7. jackie

    jackie Senior Member

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    Over 15 years I've heard it all! My surgeon (male) announced to me (as I was being prepped in the OR - I chose to remain awake for Carpel Tunnel surgery) that CFS DID NOT exist - was simply a wastebasket diagnosis and that I appeared to be a "reasonably intelligent, middle-aged (thanks a lot!) woman with too much time on my hands and that I needed to find a hobby!" This would put an end to my imagined cfs.

    The Anesthesiologist (a female) leaned over and whispered to ignore him, pointed to her little stool and said "I have it too! I just get to sit down on the job!"

    One of my first Neuros was a rude and dismissive doc...after the first visit...I brought my husband IN the ROOM with me! thinking this might intimidate the doc....but no! he told my husband that cfs didn't exist (maybe I had MS but he wasn't sure enough to treat me....when I described the strange sensation I'd been having that felt like an awful "bear hug"...he claimed he'd never heard of that and I must be mistaken - what a lie to come from a Neuro!)

    He was so obnoxious that my husband stormed out of the room (leaving me alone to deal with the doc!) - but I found him standing by the lobby elevator with tears of frustration in HIS eyes, he couldn't believe the exchange he'd just heard... but I'd been hearing the same nonsense from other docs for years.

    I hate to "generalize"...but I've noticed MORE acceptance from YOUNGER docs! The older, more set in their ways docs seem to be more cynical and less willing to "learn" OR to be "educated" by the patient themselves.

    Coincidentally I've only had one regular doc that was female...and she was a OB/GYN who had the attitude that if SHE could push through the "fatigue" of HER busy life (career, kids, etc.) then ANYBODY could.....including me.

    IMO, a female "uneducated" (re: me/cfs) doctor may be a worse enemy than a male....as they have a history of having to "push" harder to achieve success....and expect "us" to do the same (I know that in my family..the women (and unfortunately we are "heavy" on the women vs men ratio!) are more fierce and more vocal in their denial as to whether ME/CFS is even "real"!

    (I find women to be more fierce, AND more competitive as a rule, anyway (at least in MY family:eek::eek::eek:)

    Thankfully I've had a knowledgable I.D. doc for 5 years, as well as a new younger PCP who seems very willing to learn the things he doesn't already know (in fact, at our first visit I gave HIM the option of declining me as a patient...if he didn't want the "headache" of treating me long-term.)

    I explained that I was running out of time, I was NOT a quiet patient...and had no problem arguing for adequate treatment and gave him 3 pages of my me/cfs history...which he actually appreciated!

    It was he that suggested a "get-to-know-you visit" first...and then a series of visits to focus/investigate one problem at a time - until we finally get up to speed.

    This is a pretty brave move, as we have an HMO...and the Ins. Co's frown on multiple/frequent office visits - UNLESS they can be justified.

    With our "7-min. visit rule"...this doc gets MOST of "it", and realizes that not much can be accomplished (especially with the complexities of our disease) in a few minutes. ANOTHER good doc!

    (BTW...the only black-mark he gets (so far) is because he "ratted" to my HMO (about my "back pain" - he seems to have forgotten about my PHN) and THEY sent me info on CBT/GET in the mail! Which he'll get an ear-full about...at my next appointment!)

    jackie:rolleyes:
  8. Navid

    Navid Senior Member

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    when i first became ill 6 years ago this happened to me to. i was accused of dr. shopping and being depressed.

    i was advised to just relax and take a vacation. i was in hawaii when i was hit with the debilitating fatigue...so nooooo a vacation was not the answer. this advice came from male and female docs. i found ER docs, ID's and Neuros to be the most rude and condescending.

    Finally years into my illness, i found docs who were understanding, caring and curious abt my illness...they still couldn't fix me...but they were compassionate.

    my 30 something, african american male pain doc finally broke it all down for me:
    1) doctors hate to admit they don't understand or know how to fix something, so instead they blame the patient...you're depressed, crazy...etc.
    2) when they walk into the exam room and see someone like me: white, thin, 40-something with a thick file of unexplainable symptoms they immediately throw us into the category of depressed, hypochondriac woman.

    he was even honest enough to admit that when he first saw me that's what he thought, then once he started talking to me and over the years got to know me...he knew i had a real illness, but one that that mainstream medicine had very little help to offer right now.

    he is no longer my doc but i am forever thankful for his caring and curiosity.

    my pcp is wonderful too...he calls me a clinical warrior and says he gets excited everytime i bring him in new information and ideas...but these types of docs are very rare...i saw 100's of A__Holes before i found the good ones.

    you have to remain very strong and steadfast when you are sick as a dog and faced with the type of criticism and dismissal we see. i thank god for my strong self esteem and my husband's unwavering support...otherwise i don't think i would have made it thru the first year of this disease....not because of the disease but because of the way i was treated by the medical system.:Retro mad:

    :D:Retro smile:
  9. Dolphin

    Dolphin Senior Member

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    Here's one piece of research, for what is worth:

    Full Free Text at:
    http://fampra.oxfordjournals.org/cgi/content/full/22/4/389?view=long&pmid=15805128
  10. Otis

    Otis SeƱor Mumbler

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    My experience with many doctors as a male has been mixed.

    I've never been told I was it was all in my head, to my face, but oftentimes the doctors would express their concerns about depression in their notes without ever saying anything to ME. I would have found a shrink, got cleared of depression and moved on to a new Dr. Instead it was an unspoken undercurrent while receiving mediocre care, especially from the primary offender. It's shocking to read doctors notes and realize that the "supportive" clinical experience was all a sham.

    Being abused is obviously worse but this kind of betrayal is not helpful either.

    More recently I've had a better experience and learned to get a copy of the records, regardless of how nice or helpful a Dr. may seem. You may need those records later.
  11. serenity

    serenity Senior Member

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    Austin
    that is really good avcie Otis, i will do it - thanks! :)
  12. darkrobot

    darkrobot

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    I don't think it's a problem that is specific to women- most doctors don't listen, full stop. There have been many occasions where I've been describing a problem to a GP and he/ she has begun talking over me before I can finish the sentence. Why is actually listening to the patient so low on their list of priorities? Surely it is crucial for proper diagnosis and treatment? I have all but given up on the NHS, who seem to use depression as code for "I don't have a clue and I'm not really interested in investigating further, as that would meant admitting I don't have a clue which I will not do under any circumstances".

    Meahwhile, the patients suffer.
  13. RustyJ

    RustyJ Contaminated Cell Line 'RustyJ'

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    OK, I'll bite. I think the fact that this thread exists may go some way to explain. By the way, I am a male, if some doubt still exists. Males with ME/CFS cop the same prejudices from doctors, the same doubts... exactly the same. Yet you would be far less likely to see a male start a thread about gender-based prejudice. By the way please don't take too much offence. I do believe gender bias exists. I just think that in this case both males and females are treated as whining, hysterical, mental cases.
  14. usedtobeperkytina

    usedtobeperkytina Senior Member

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    In Osler's Web, the researchers and clinicians trying to get other researchers to confirm the biological abnormalities they saw in a patient (from the outbreaks) learned quickly to send males instead of females. I am speaking mostly of the neurological tests, from what I recall.

    I think sexism is part of the story, not only on patient to doctor level but also at CDC researcher level.

    Why doesn't CFS get reasonable amount of research funds by federal agencies?

    But, I think it is harder for a man to be diagnosed. I know a man who went many years without diagnosis of fibromyalgia. He had to quit his job of band director. He later came back as band director of middle school, he never has gone back to directing high school. There were lots of talk at the time about the fact he had pain and had to quit after years of trying to get diagnosis. Later, much later, years later, I was told they found out it is fibromyalgia. I guess the doctors just couldn't imagine a man would have fibromyalgia.

    Tina
  15. RustyJ

    RustyJ Contaminated Cell Line 'RustyJ'

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    It has been "said" (cant provide documentation) that men are more reluctant to seek medical advice for any condition. Men are less strident in their efforts to seek medical attention and less strident in describing their condition (this is a broad generalisation, please forgive me). This is part of 'machismo'. In a male-oriented workplace a man with ME/CFS is seen as weak, forced to silently accept his fate and fade away. Slip into the cracks. A practical example of discrimination against men is the disparate amounts (compared with deaths) spent by governments on breast cancer vs prostate cancer. Indeed the Australian government has begun to target men in some of their health campaign because of a reluctance by men to seek medical advice.
  16. serenity

    serenity Senior Member

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    Austin
    Rusty, i don't take too much offense - but a little ;)
    there are more women than men out there that have it. so maybe that's why the thread was started by a woman or there are more women whining? & i think it's pretty gender biased to say that a man wouldn't start this thread.
    anyway, no big ... i don't care really. i think it's probably really awful for a man to have this, even more so than a woman. because of the gender bias out there.
    i do not think that men are treated differently or maybe they are again i have no opinion, but come on you know you were baiting us gals with that post! haha! you gotta expect a response, tho i swear mine is lighthearted. :)
    oh & i agree with your 2nd post. :)
    in my experience, my doctor who i like very much listens more when my husband joins me for the visit.
    that's all i can say.
    i can assure you i have no interest in argument, & it seems that maybe you are a bit sore about the matter? & i wouldn't blame you. i think it's got to be horrible to be a dude with this disease.
  17. RustyJ

    RustyJ Contaminated Cell Line 'RustyJ'

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    Hi Serenity. I was baiting, a little. These things shouldn't get too serious. I think it is enough of a burden to have ME without thinking that you've been unfairly treated because you're a women. Yes I do think some women would be unfairly treated. Yes I do think some men would be unfairly treated. It would be interesting to survey how women doctors treat female ME patients. I believe even some female doctors would treat women patients unfairly, conditioned as they are by the male establishment.
  18. serenity

    serenity Senior Member

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    Austin
    yeh i think so, i had almost forgotten already because i had put it out of my mind - but the last doc i saw literally said to me "i saw women like you back in medical school." he said it, can you believe?!
    so you know, i think that is probably why the article that started this topic was written.
    by the way, even i am tired of hearing about breast cancer - & i have a really good friend who just had a double mastectomy! please no one take offense of course i care about the disease, but the idea that we need any more awareness for it baffles me! i think we are aware of breast cancer by now. i think maybe some other diseases i can think of could use a bit more awareness, yes?
    ;)
  19. Koan

    Koan Be the change.

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    Hey Rusty,

    Here's the thing, though, women are treated as whining, hysterical, mental cases when they have a heart attack, a burst appendix, a kidney stone, a stroke...

    Welcome to our world.
  20. wciarci

    wciarci Wenderella

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    Don't forget about endometriosis. When I was in high school with this my Mom took me to a male OBGYN who told her and myself that I was just afraid of becoming a woman. I never complained again until I ended up in the ER in my thirties and was told this is real, you have it and it can be treated. Women unfortunately have had bad experiences with the medical community for many issues, this is just the last straw for many. I am not saying that men haven't had this experience with ME, it is just that usually, it is the first time, not the 30th. Look, I am not against men, I have male friends, I am just against the male establishment. Different complaint. And yes, some female doctors, working in this environment take on the mantle of their male mentors and peers and it isn't pretty. But they weren't until recently part of the 'establishment'.

    Wendy

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