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Discriminatory Medicine: When Medical Care Is Not the Same for All

By E. Rose Kasweck

When I first started working as a plaintiff’s medical malpractice attorney, I was struck by how many of our clients, people who had suffered terrible and avoidable injuries at the hands of their doctors, were women or minorities.

I know the population of North Florida is diverse but, even so, the numbers I was seeing seemed disproportionate.

I quickly learned, however, that it was no mistake, and nothing unique to our firm or our part of the country either. These groups do, on the whole, tend to be more vulnerable and receive poorer medical care. And although this is not typically the result of racist or sexist doctors setting out explicitly to discriminate, the impact of these systemic and often unconscious biases is still felt.

A 2012 study found that a majority of primary care physicians in this country harbor unconscious racial biases against their African American patients. Without realizing it, these doctors tend to take less time examining and discussing treatment options with their Black patients and are likely to involve them less in making their own treatment decisions. This not only results in poorer outcomes, but in an environment where African American patients do not welcome in the healthcare system because their concerns are not being taken seriously. This, in turn, results in these patients being less likely to seek care in the future, compounding the problem, and resulting and even poorer outcomes.

Women often face similar concerns about being taken seriously by their doctors. Although we have moved on from the days of hysteria, women often find that they have to fight to make themselves heard and have their concerns addressed. Even in areas such as gynecology or breast cancer treatment, it is not uncommon to encounter paternalistic doctors who think they know what’s best without asking the opinion of their female patients.

One thing I could not believe when I began investigating the ways that different groups encounter the healthcare system is with how heart attack symptoms are handled and categorized. Even though heart disease is the number one killer of women, the heart attack symptoms that women tend to experience more often than men are still considered “atypical” symptoms across the board. Chest pain and left arm discomfort are common signs of heart attack in both men and women. But women often present with other symptoms, such as shortness of breath, nausea and vomiting, and back or jaw pain. These symptoms are not at all atypical, in the common sense of the word, for women. But because the “typical” heart attack symptoms are considered to be only those that occur most often in men, women’s heart attacks are less likely to be recognized for what they are and are often written off as something less life-threatening, such as the flu, acid reflux, or just normal signs of aging.

Women and racial minorities are not the only people who face these problems. People with mental illness often have to fight to be taken seriously, including in the medical realm. Conscious and unconscious biases affect the way that LGBT people experience the healthcare system. And I can only imagine the struggle of foreign born patients trying to obtain medical care in an environment where they do not speak the native language.

These discriminatory factors are often so subtle and entrenched that they would be impossible to prove in a court of law. But at Barrett, Fasig & Brooks we fight for the rights of medical malpractice victims, no matter the reason.

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