Medical mistakes happen across all patient categories and in every medical specialization. However, a few factors have combined to make women’s healthcare – including but not limited to reproductive issues and maternity care – an especially common site for problems related to provider-patient communication. Gaps in medical knowledge arising out of the ways clinical trial participants have historically been selected have resulted in a “standard” understanding of human anatomy and physiology that often leaves out of account potentially important endocrinological and immunological differences between male and female bodies.
Additionally, a combination of social norms and assumptions internalized during medical training can lead women to be less assertive in explaining their symptoms and seeking care than their male counterparts, and medical practitioners to be less attentive in listening and less proactive in ordering diagnostic procedures and pursuing aggressive treatments – even for conditions that affect both genders at broadly similar rates.
All of these issues can contribute to increased risks of delayed or missed diagnoses and inappropriate or inadequate treatment – medical mistakes which in turn carry negative implications for immediate and long-term patient outcomes, and substantially impact women’s health, especially in areas directly related to maternity, childbirth, and reproductive care. Fortunately, there is a growing awareness that women have options for seeking support and representation as they navigate the often challenging process of accessing medical care. To learn more, schedule a consultation with a maternity and birth injury attorney from Erin Marshall Law. In New Mexico, call (505) 218-9949 today.
What Are Medical Mistakes?
“Medical mistakes” is an umbrella term that encompasses a variety of errors that may occur during patient intake, assessment, diagnosis, and treatment. These mistakes can range in severity from minor gaffes, quickly corrected, to life-altering or even life-ending events. According to a training resource made available through the National Library of Medicine, some of the most common medical mistakes include:
- Surgical mistakes
- Erroneous or missed diagnoses
- Wrong drug dosage or formulation
- Hospital-acquired infections
- Communication failures
While medical mistakes can impact patients in any category, with any condition, a number of factors can contribute to increasing the likelihood of such mistakes when healthcare providers are treating female patients. Maternity and postpartum care can be especially thorny areas within the overall field of medical practice; as recently as July 2024, the White House released a two-year update on its ongoing effort to address what the administration has called the “maternal health crisis.”
What Makes Women’s Healthcare Different?
A number of factors can lead medical professionals to respond differently to patients based on their gender, whether consciously or unconsciously. The effects are not always immediately harmful, but they do contribute to an overall climate in which the experience of seeking medical care tends to be different for women than for men.
Importantly, gendered differences in medical training and healthcare providers’ perceptions do not have to be rooted in deliberate misogyny to have cumulative effects that influence patient outcomes – and not all gender-based differences in approach are inherently wrong or misguided. However, gaps in training during medical school and early clinical practice can easily combine with social norms and perceptions – including, but not limited to, gendered expectations regarding medical “toughness,” expected pain levels, and patient complaints – to create the conditions for poor communication between patients and healthcare providers. All too often, these factors result in missed diagnoses and lengthy delays in treatment, with commensurate impacts on women’s overall health. Understanding some of the factors at work is crucial to developing a multifaceted, patient-centered approach to addressing them.
Historical Roots of Contemporary Outcomes
Women were routinely excluded from participation in clinical trials until 1993, according to the American Association of Medical Colleges (AAMC). The reasons for these systematic exclusions were at least partly “good,” in the sense that they were structured to a large extent by attempts, within the medical research field and its corresponding regulatory frameworks, to apply the classic guiding ethos of the medical profession: First, do no harm. A major impetus for clinical trials involving pharmaceutical interventions, in particular, is to observe how patients respond to treatment. These trials are typically set up not only to determine whether the drug has its intended therapeutic effects (usually defined as the “primary endpoint” in the research protocols), but also to monitor for and identify any unintended side effects.
Monitoring for adverse effects in otherwise healthy adults who have granted their informed consent can be a time-consuming, labor-intensive task that still occasionally misses capturing data whose importance is only recognized in hindsight. Monitoring for adverse effects in a developing fetus can be orders of magnitude more difficult, and the potential for long-term, irreversible consequences in the form of miscarriages, birth defects, and a host of other disruptions to fetal development have long worked to discourage researchers from enrolling female participants in clinical trials, especially if the research volunteers are of childbearing age.
Missing Data and Inadequate Training
Unfortunately, however, the lack of clinical data on bodies with two X chromosomes – bodies capable, at least in most instances, of carrying a child and giving birth; bodies that produce breast milk and shed uterine linings – has left medical researchers, and as a consequence generations of medical students and therefore medical practitioners, all too often in murky territory regarding not only how these bodies will respond to “standard” treatments, but even whether and when such treatments are needed. A 2023 study available in preprint via the National Library of Medicine found that – across an impressive 112 diseases, both chronic and acute – the average length of time between onset of symptoms and diagnosis of disease was longer for women than for men, even when controlling for factors such as health insurance. Notably, the delay held even for diseases whose clinical presentation does typically vary by gender. Even for heart disease – the leading cause of death for both men and women, nationwide – the National Heart, Blood, and Lung Institute points out that women may experience “delays” in treatment for heart disease because healthcare providers are less likely to order diagnostic procedures when the patient presenting with symptoms of cardiovascular illness is female instead of male.
The composite picture painted by these cumulative facts suggests that biological differences, by themselves, may not be fully adequate to explain why late and missed diagnoses are uncomfortably common in women’s medical care – with frequently devastating implications for patients’ treatment and eventual outcomes. An experienced attorney with Erin Marshall Law may be able to help you understand how some of these factors may relate to your individual medical case.
Biological Factors
The biological differences between female patients and the historically male participants in clinical research on which much medical training is based may not fully explain poor doctor-patient communication in women’s healthcare, or the statistically significant disparity in time to diagnosis between male and female patients presenting with similar symptoms, but this does not mean that biological factors are irrelevant.
On the contrary, the overwhelming emphasis on reproductive issues in public health messaging aimed at women and their healthcare providers can serve to disguise a wider array of sex-specific characteristics that may impact both susceptibility to specific diseases and indications for patient care. These differences include not simply sexually dimorphic anatomical structures (e.g., ovaries vs. testes, the presence vs. absence of a uterus), or even differences in the endocrine system and hormone production (including not just the balance between testosterone and estrogen but important hormones related to pregnancy and lactation), but also key immunological differences that lead to further divergences in susceptibility to infections vs. relative risks of developing autoimmune and inflammatory conditions.
Inadequate Training and Poor Communication
One of the most frustrating aspects of navigating medical care as a woman, or of working with women who are living with the consequences of avoidable medical mistakes, can in many cases be the grim reminder that inadequate knowledge of female bodies, and inadequate training in diagnosing and treating female patients, can work hand-in-hand with a socially-normative tendency to dismiss women’s own reports of their symptoms as they attempt to access care.
The student-led Global Research and Consulting initiative from the University of California at Berkeley notes that fewer than 30% of medical schools provide instruction in addressing gender-specific health needs. The clear implication is that individuals entering the medical profession frequently leave their formal training to begin clinical practice underprepared with respect to any sex-specific variations in symptomatology, disease progression, or treatment indications.
The same report also indicates that healthcare professionals are apt to write off reports of pain made by female patients as a normal condition of women’s bodies, rather than looking for underlying causes. While this failure to investigate may look like an error in diagnosis, it is also a failure in communication: Too often, doctors and other medical professionals fail women not only providing inadequate information to these patients, but by neglecting to take seriously the information the patients themselves are providing.
Legal Advice and Advocacy
Women’s health care in the United States continues to suffer from a complicated set of compounding factors. Inadequate training in gender-specific symptoms and treatment indications for common health conditions leaves medical professionals underprepared for treating patients who do not inhabit the male bodies historically recruited for clinical trials and often presented as normative during formal education for careers in health care, while chronically hampered doctor-patient communication makes it difficult for many patients to advocate effectively for their own interests. The cumulative result of these dismal factors shows in the high incidence of medical mistakes in women’s healthcare across all conditions – but nowhere are the stakes more clearly demonstrated than in the high incidence of maternity injuries throughout the United States. If you are struggling with the consequences of some of these medical mistakes – or if you are still attempting to navigate the frustrations of the healthcare system in order to resolve them – you do not have to fight an uphill battle alone. Connect with an attorney from Erin Marshall Law experienced in maternal medicine cases. Call (505) 218-9949 today to schedule your consultation.
