Some of the saddest and most frustrating aspects of seeking medical care as a woman can stem from the gender bias in healthcare systems – a bias which, all too often, leads directly to women’s health disparities compared to the long-term outcomes enjoyed by men with similar conditions. Many doctors and other healthcare providers are under-informed on the ways symptoms of common conditions that can affect anyone may manifest differently depending on a patient’s sex. Some medical professionals are also inclined to dismiss female patients and the symptoms they report, often leading to missed or delayed diagnoses of potentially life-threatening conditions such as heart disease. If your health has been negatively impacted by misdiagnosed heart disease in which the gender bias in healthcare may have been a factor, a conversation with a member of the compassionate and knowledgeable team at Erin Marshall Law, dedicated to addressing women’s health disparities, may be able to help you evaluate your options. Call our office today at 505-218-9949 to schedule a consultation.
Recognizing the Gender Bias in Healthcare
Roughly one in three women will die from heart disease, according to the American Heart Association (AHA), with the Centers for Disease Control and Prevention (CDC) attributing 19.1% of female deaths and 20.1% of male deaths in 2021 to non-specific heart disease (a category which excludes some causes, such as stroke, that the AHA typically includes in estimates of total heart-related deaths). In other words: Heart disease kills men and women and roughly similar rates, and yet – as Go Red for Women, a national advocacy group focused on addressing women’s healthcare disparities in heart disease prevention and treatment, points out – many women and their healthcare providers are inclined to think of heart disease as a problem primarily affecting older men.
Women’s Health Disparities and Patient Outcomes
The effects of this misperception are grim. The National Heart, Lung, and Blood Institute reports that “younger” women – a category that unavoidably includes many at risk of pregnancy-related heart complications – are more likely than men to be sent home without diagnosis or treatment after going to a hospital emergency department. A 2018 fact sheet presented jointly by the AHA and the American Stroke Association (ASA) affirms that women are more likely than men to suffer “adverse” outcomes, including death, within one to five years of a heart attack.
Under-Treating Heart Disease in Women
In all age categories, women with acute coronary syndrome are more likely than men to experience heart attacks and strokes, more likely to be re-admitted to the hospital after discharge, and more likely to die as a result of complications – yet the same AHA/ASA fact sheet also reports that women are less likely than men to be offered options for cardiac rehabilitation, less likely to receive an implantable device for managing an irregular heart beat, and less likely to be prescribed statins – often considered the standard of care – for the management of high cholesterol. The average age for an initial diagnosis of heart disease is slightly higher for women than for men, according to a 2020 article published in the Journal of the American Heart Association, but it is not fully clear whether the difference in age at diagnosis is due to women developing symptoms of cardiovascular disease (CVD) later in life than their male peers vs. reflecting the often lengthy delays female patients experience between the onset of symptoms and a confirmed diagnosis.
Misdiagnosed Heart Disease and Missed Opportunities for Treatment
A major factor that may contribute to women’s healthcare disparities compared to men, especially in the diagnosis and treatment of cardiac disease, is that doctors are less likely to perform diagnostic tests on female patients, less likely to reach an accurate diagnosis even if tests are performed, and at the same time less likely to prescribe aggressive treatments even after a cardiac diagnosis, than when the same doctors are caring for male patients. A 2010 study published in the Netherlands Heart Journal and available through the National Institutes of Health (NIH) concluded the “under-recognition” of both heart disease prevalence in women and the differences in symptom distribution between men and women led to an underrepresentation of women in clinical trials (likely perpetuating the lack of familiarity with sexually dimorphic symptoms) and a “less aggressive” treatment recommendations.
The relationship between lack of testing and lack of diagnosis may appear straightforward at first glance – after all, it is obviously difficult to diagnose a condition for which no tests are conducted – but the picture is complicated by the fact that medical professionals will in many cases not only fail to diagnose heart conditions in women, but actually misdiagnose heart disease, with or without testing, as another condition. A study of 128 physicians published in 2009 in the Journal of Women’s Health (available to the public through NIH) found that when researchers asked doctors asked to review video presentation of symptoms and provide their estimates of the likeliest diagnosis, along with the degree of certainty they felt regarding their estimates, the physicians participating in the study misdiagnosed heart disease as “a mental health condition” in 31.3% of middle-aged female patients, in sharp contrast to the 15.6% of men who received the same misdiagnosis.
Know Your Rights as a Patient
Occasional misdiagnosis is an unavoidable reality of the imperfect world of medicine, where “textbook” examples are rarely seen in actual practice. However, doctors and other healthcare providers have a responsibility to treat all patients in keeping with the standard of care. Women who have suffered long-term adverse outcomes from misdiagnosed heart disease or inadequate treatment stemming from the gender bias in healthcare may have legal recourse to help recover some of their lost expenses and compensate, at least to an extent, for their diminished quality of life. To learn more about your rights as a patient and how legal advocacy can help to address women’s health disparities and close the gender gap in heart health, contact Erin Marshall Law. Call 505-218-9949 today to set up an appointment with a member of our New Mexico team.
