652 Healthcast – Do You Feel Dismissed by Your Doctor?

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Every day in my office I hear horror stories about how my female patients are dismissed by the doctors they trusted to help them resolve their problems such as:

· Hot Flashes and night sweats

· Loss of libido

· Rapid weight gain

· Brain Fog

· Insomnia

· Arthritis associated with lack of hormones

· Anxiety/Depression starting in their late 30s

· New irritability

· New Migraine headaches

· Lack of motivation

· Fatigue

There doctors dismissed them, telling them they were just getting old, or they were "babies" because they can't stand a few hot flashes, the doctor changed the subject, or my most unfavorite response to a plea for help, "It is just in your head". Many other demeaning responses have been recorded, but I am appalled at these responses. For a patient it takes so much strength to ask these questions, and patients are literally at the doctor's mercy. In case you didn't get it, the doctor who says these things is covering up for his/her own ignorance. These are methods used by a person in charge who is challenged to answer a question he or she doesn't have an answer for. In general, these doctors are men and women, however women have been trained by men and they taught women to do what they had been doing for years. These "medical" responses are used to belittle the patient to hide their own lack of knowledge. If you are dismissed in this way you should not put up with it. You can just never schedule with that doctor or practice again or you can find a new doctor who will hear your distress and treat you or tell you they don't know how to help and refer you to someone who does. You shouldn't put up with dismissive doctors.

Another dismissive phrase used by many doctors since the inaccurate WHI study is you're your doctor tells you that he doesn't BELIEVE in hormone replacement. You should respond that hormone replacement is not a religion, it is a medically necessary treatment for menopause! Board certified OBGYNs and Family Doctors should be trained in this treatment.

We women have not only been dismissed by doctors, but also by the Colleges (eg. American College of Obstetrics and Gynecology) that tell doctors how to practice. In my OBGYN training I was taught that most of women's complaints were because they were depressed so they told us to put women on anti-depressants that just make them numb, but that did not treat our symptoms. Misogyny is alive and well in the practice of medicine, even in the group of doctors who are supposed to dedicate their lives to the health of women, Obstetricians/Gynecologists.

Discrimination CAN be taught, and I believe medical training still teaches these male oriented beliefs to new doctors who are almost 50% women. Medical schools allow women to become doctors because we are qualified, and they can't discriminate anymore. When I was trained and for a few decades after I became a doctor, you would think I was a second-class citizen. I was left out of resident training run by the residents (almost all men). Those older male doctors treated me like and. Interloper and some even told me I was not supposed to be a doctor because of my sex. …I was never treated as if I was an equal from the minute, I started medical training and women now practicing over the age of 50-something were all trail blazers and were told all women were hysterical and complainers. I never accepted this view but now know that women complain because we are not believed and not treated with a treatment that really relieves our symptoms.

After my hysterectomy 2002 I was in private practice with like-minded women in Balanced Care for Women, and they tried to help me but admitted they didn't have the knowledge. I had terrible symptoms that I now know was from lack of testosterone. The endocrinologists and primary doctors I sought help from belittled me and treated me like I was making the symptoms up! The worst experience I had was with endocrinologists who were women just saying what their male counterparts had taught them without really thinking. They "drank the Kool-Aid "from their male teachers and treated me like I was crazy because they were unwilling to admit they didn't know what was wrong with me! I grew up in medicine (1977-now) under a cloud of sex discrimination and when I needed them most at the age of 47 my sister-doctors failed me…I know intimately how my patients feel when seeing doctors that demean them.

There has been a Federal Law to protect women since 1972, when the US government passed Title IX a Federal Civil Rights Law amendment, but in my experience the law was violated all the time.

Title IX 1972 (my interpretation is simplified and not the actual word for word amendment)

Sex discrimination is unlawful in choosing an employee, a medical student, funding for sports at the collegiate level.

I am a champion for women and women's rights. We should require every medical student to be taught about this so the teaching from one generation to another doesn't contaminate young doctors. Without this action the misogyny in medical care will continue. Recently The DEA required doctors to take an 8-hour course to help them learn to communicate with substance users in a more kind and sympathetic manner. The course's direction to be compassionate and supportive to substance users should be taken for treating women as well. That would be a giant step for all of us. Wiping out discrimination takes generations but must start somewhere and that should be taught at the beginning of medical training.

After we conquer the minds of physicians then we will have to work toward equity in drug development (all drugs are tested on men, but women were not tested on new drugs until 2014), the FDA, the DEA, and Pharmaceutical companies. To make this happen patients will have to take part and not accept dismissive and discriminatory behavior by their treating doctors.