Coping With Provider Bias
- New research published in The Proceedings of the National Academy of Sciences (PNAS), has revealed that pain-relief medications are less likely to be administered to women than men who are complaining of the same type of pain.
- When it comes to your health, be a little pushy. You know your body better than anyone else. When you see a doctor for a problem, don’t hesitate to make sure that your question is fully answered and that you are comfortable with the plan moving forward.
- From a doctor’s perspective, every problem should have a diagnosis, a treatment, a plan for follow-up, and a plan for what happens next if the treatment doesn’t work.
- Remember, persistence is key when it comes to your health. If you feel like your condition is getting brushed off, change providers and don’t stop until you can get the proper medical care.
Too many women say their concerns are ignored by the doctor. Millions of us and celebrities such as Lady Gaga. Pain management decisions for female patients are provided in a biased manner, according to a new study published in The Proceedings of the National Academy of Sciences (PNAS), a peer-reviewed journal of the National Academy of Sciences (NAS). The
new research , which analyzed medical records of female and male patients across the U.S. and Israel, revealed that pain-relief medications are less likely to be administered to women than men who are complaining of the same type of pain. The study looked into more than 21,000 admissions into Emergency Room departments and found that doctors are 10 percent less likely to ask female patients to rate their pain when coping with a serious health issue.
RELATED: How Famous Chronic Pain Sufferers Like Lady Gaga, 37, Pushed Through – New Epidemic of Sufferers Revealed in Study Study authors have explained that an "analysis of archival datasets of pain management decisions as well as a controlled experiment, testing whether pain management differs by patients' sex," was conducted to obtain the results. "We present robust evidence showing that physicians' and nurses' pain management decisions in emergency departments disfavor female patients compared to male patients," the study authors explain.
RELATED: Diversifying Clinical Trials and Increasing Screenings Through Education and Policy; Key Takeaways from SurvivorNet’s ‘Close the Gap’ Conference "Notably, female patients are less likely than males to be prescribed pain-relief medications for the same complaints. We argue that female patients receive less pain treatment than they should, which may adversely impact their health." Overall the authors address the issue for a "critical need to address psychological biases in healthcare settings" to allow for "fair and efficient treatment for all."
Coping With a Diagnosis
According to
Newsweek , the study also points out that men and women dealing with the same condition, for example a fractured foot, could be treated vastly different. Study author and professor at The Hebrew University, Shoham Choshen-Hillel said, "Our research reveals a troubling bias in how women's pain is perceived and treated in emergency care settings." He further states, "This under-treatment of female patients' pain could have serious implications for women's health outcomes, potentially leading to longer recovery times, complications, or chronic pain conditions." It's also interesting to note that the bias occurred regardless of whether the practitioner was male or female.
Provider Bias in Healthcare: How To Change The Dynamic Additionally, to further validate the study's findings, a controlled experiment involving 109 nurses in a situation where patients were being triaged, female patients' pain was described as less intense despite the information they had been given. "This disparity extends across medical practitioners, with both male and female physicians prescribing less pain-relief medications to females than to males," the study authors explain in their abstract. "Additional analyses reveal that female patients’ pain scores are 10% less likely to be recorded by nurses, and female patients spend an additional 30 min in the ED [Emergency Department] compared to male patients."
Avoiding Provider Bias – Is Your Doctor Understanding You?
While your doctor has undergone years of training and practice, they are still human, and may come with their own set of biases that can impact how they treat patients. To combat these biases and really get the most out of your interactions with your doctor, you should provide her or him with plenty of information about your life and ask plenty of questions when things aren’t clear. To better understand how you should approach conversations with your doctor, we previously spoke with
Dr. Dana Chase , gynecologic oncologist at Arizona Oncology. According to Dr. Chase, physicians, like many of us, can be a bit biased when seeing patients. She made it clear that these biases are rarely sinister, but rather unconscious and more subtle. She explained, “We have certain beliefs that we don’t know about. We might look, for example, at an older woman, and just by the way she looks we might make certain assumptions, and we might not even know that we’re making these assumptions.
Let’s Talk About Provider Bias Clearing up misconceptions is important, but so is understanding what your doctor is telling you, Dr. Chase noted. Overall, she advises women to speak up and ask questions when they don’t understand something. “It’s never a bad thing to ask for something to be repeated, or to ask the doctors to explain it in different terms.” So next time you go to your physician, speak up if you need clarity, so your doctor can understand you and you can understand them.
Coping Mechanisms for Pain Management
Whether you're dealing with pain while coping with a health issue in a hospital environment, or even just living with chronic pain, it's important to understand that you're not alone. According to the
Centers for Disease Control and Prevention , 20% of Americans are living day-to-day with chronic pain. The National Institutes of Health (NIH) is conducting basic pain research to develop strategies and potential medications to better manage pain. The research focuses on key areas including facial pain and how – in some cases – protein increases sensitivity to painful and non painful stimuli.
RELATED: Clinical Trials Can be Life-Saving for Some Research involving mice indicates that rodents with high levels of Cdk5 (a type of protein called cyclin-dependent kinase 5) showed larger calcium surges, indicating that their pain responses were intensified.
“This heightened pain sensitivity is similar to a condition called allodynia. Allodynia causes pain in response to something that isn’t typically painful. The research team was able to reduce pain signaling in those oversensitive mice by blocking their Cdk5,” NIH Distinguished Investigator Dr. Kenneth M. Yamada explained. Other areas of research include learning how sound reduces pain and ongoing clinical trials studying pain perception and lower back pain. Of course, pain management comes with risks especially when powerful painkillers, such as opioids are involved. The Centers for Disease Control and Prevention
recommends seeking treatment opinions that don’t involve opioids to treat pain when viable. Medicines like over-the-counter painkillers including acetaminophen, ibuprofen, and naproxen have fewer side effects. Other alternatives to opioids include physical therapy and exercise.
How To Seek Help
While National Cancer Institute Chief of Surgery
Dr. Steven Rosenberg specializes in cancer, his advice on pushing for multiple professional opinions can also apply to chronic pain sufferers. As we highlight in several areas of SurvivorNet, highly respected doctors sometimes disagree on the right course of treatment, and advances in genetics and immunotherapy are creating new options. Also, in some instances, the specific course of treatment is not clear-cut. That's even more reason why understanding the potential approaches to your disease is crucial.
Cancer Research Legend Urges Patients to Get Multiple Opinions “If I had any advice for you following a cancer diagnosis, it would be, first, to seek out multiple opinions as to the best care, because finding a doctor who is up to the latest of information is important,” said Dr. Rosenberg. “And it's always important to get other opinions so that you can make the best decisions for yourself in consultation with your care providers.” A somewhat new pain treatment option is cannabis. Cancer patients all around the world talk about how beneficial cannabis is as an option for their treatment. Many of our doctors recognize the potential benefits of cannabis as a part of integrative therapy, but it's important to note, not as a cure in itself. “Integrative therapy is when patients come to see me when they want to add alternative or complementary therapies to their conventional treatments,” says
Dr. Junella Chin , an integrative cannabis specialist. Marijuana can be a helpful tool in combating the negative side effects of both cancer and chemotherapy. It can help with nausea, loss of appetite, pain and depressed mood or anxiety. "Medical cannabis, if you think about it, it's the only botanical medicine that can help nausea, increase appetite, decrease pain, and elevate mood," Dr. Chin told SurvivorNet, in a previous interview. She noted that a lot of people who are undergoing chemotherapy as part of their cancer treatment live in a state where medical marijuana is available and are using it for relief. Some doctors will prescribe a generic version of marijuana, called Marinol, to treat these side effects. But Dr. Chin would rather use the real thing to help her patients. “That is much more effective in increasing appetite and decreasing pain for my cancer patients," she said.
Contributing: SurvivorNet Staff 
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