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Medical Treatment Varying by Sex and Race
Is there truly equality?
Do treatments by doctors vary by sex and race? Ideally, no.
Doctors should be treating everyone equally and with the same
quality of care. However, a recent study concluded that doctors'
decisions are, indeed, influenced by the sex and race of the
patient.
The Study
The researchers made a number of videos in which eight actors,
four of each gender and four of either black or white race,
described symptoms of chest pain. The eight actors took turns
portraying two different patients.
These videos were shown to 720 doctors, about three quarters of
whom were white males. It was found that the race and sex of the
actors did influence the decisions of the doctors, who were
unaware that these were actors and not real patients. In 90% of
cases, the doctors recommended diagnostic testing for the
patients. Treatment recommendations varied by sex and race.
Black women were 60% less likely to be referred for cardiac
surgery than were white males, even though they had an identical
list of symptoms and results. Black males and white females were
each 40% less likely to be recommended for the same surgery.
Another Factor
Although women and minorities should be aware of the potential
for physician bias, there may be other factors involved. Women do
show different symptoms, have different test results, and respond
differently to treatments for the same diseases than do men. These
differences are the basis of the new specialty of Women's Health.
The Women's Health specialty is not Obstetrics and Gynecology,
which only treats the female organs. Women's Health specialists
are pioneering the research uncovering gender differences in
various diseases found in both sexes. They are determining how
treatment should be different for women in order to maximize a
woman's chance of survival. The same is true for different ethnic
and racial groups, as well.
With that said, you would wonder if these results were due to
astute physicians being well informed about the differences
between male and female heart disease. We do not know the
details of what symptoms the patients pretended to have.
However, it would be reasonable to strongly suspect that the
results were indeed due to gender biases. A forty percent
difference in treatment is too large a gap to explain with our current
knowledge of differences. In fact, there are no differences known
that would make a doctor legitimately recommend surgery in a
man, but not in a woman. Some of the undertreatment of female
patients with heart disease can be attributed to the myth that
women have lower rates of heart disease than men do. This false
belief is almost as strong among doctors as the public. What's
more disturbing about these findings, is the implication that the
undertreatment of certain groups is also due to doctors'
devaluation of women and minority men as people. This suspicion
is raised in the results in the black patients. Blacks actually have
higher rates of heart disease and this is well known by doctors.
Yet, the black men were treated less than the white men were.
Doctors need to be better educated on the true rates of heart
disease in women. They need to be educated on the differences in
male and female heart disease. However, none of that will do any
good unless they view all their patients as equals. This is
something that cannot be accomplished with a seminar.
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