Doctors misdiagnose patients due to bias, risk serious harm

Credit: Anna Boyle/ Credit: Anna Boyle/
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“It’s nothing — she’s a girl, and girls over-exaggerate their pain!”

One month later and I was committed to a wheelchair for the next five months.

Being overlooked by doctors as a result of their own personal biases can often leave their patients with serious untreated medical conditions. Misdiagnosis is the third leading cause of death in the United States — and certainly bias must play a role. I was lucky that it was only severe stress fractures in my feet that got neglected by an orthopedic surgeon, but for others, not being taken seriously by a doctor may be a matter of life and death. Such was the case with Elle Mayday, who, after complaining of lower back pain, was told simply to engage in exercises to strengthen her core. Fast forward after repeated encounters of not being evaluated seriously to her real diagnosis: stage III ovarian cancer. Had she not persisted for a thorough examination, she might well be dead.

Patients face doctor discrimination on multiple platforms — gender, race, weight, religious or political beliefs. In a recent national survey, 40 percent of doctors reported feeling bias towards patients due to different factors. However, 85 percent claimed that this bias did not affect the way they treated their patients. But are those who admit to bias really in a position to objectively evaluate whether or not it affects their practice? And what about those who don’t admit to their bias? Does that make it even worse?

If I hadn’t insisted that my feet hurt terribly and if I had gotten an MRI any later, the bones in my feet may have “shattered” completely and led to an even more complicated and difficult recovery. At the time of my injury I was on a soccer team and technically playing on two due to the shortage of players on the junior varsity team in my high school. I relayed that fact to the doctor during the first visit and it should have been taken into consideration as valid indicator that I might have gotten somehow injured.

Yet, because the X-rays did not show any sign of injury, I was told to merely “take it easy” and take ibuprofen if I experienced pain. I finally had an MRI taken upon my mother’s demanding it from the doctor, and when the surgeon examined it he sheepishly admitted “I did not believe you were in so much pain,” and ordered me to stay off my feet, scoot around the house on my derriere and knees, and not return to school until I had my wheelchair, an object I was glued to over the course of the next five months.

Expressing personal bias leads doctors to provide inferior care to patients with the same medical condition that would get much more attention and better treatment from a different doctor without the bias or someone aware of his or her own biases and able to overcome them. Often times, women get less medical attention than men and are dismissed as being too emotional and exaggerating their physical discomfort. A large part of me thinks that this is the result of a male dominated field, particularly when it leads to neglect as the result of perpetuating assumptions related to gender.

This disparity in care is also widespread among obese patients, who feel that their doctors fail to take them seriously, unwilling to look past the large numbers on the scale. Such was the experience with Patty Nece, who sought an orthopedist after increasing hip pain. Her doctor, without even properly examining her, provided her with an “obesity pain” diagnosis. Only later she discovered she had scoliosis, a condition unrelated to her obesity.

Doctors are human beings and, as is the case with humans in general, are not error-free, and their reasoning is subjected to emotional and psychological factors, skewing their objectivity. However, the nature of their work and the responsibility for protecting human life that rests on their shoulders puts them in a unique position of moral obligation to strive for high self-awareness.

It is ironic that someone who is a doctor — the person you trust to take care of your health — can turn you away by something as trivial as a difference in perspective or not take you seriously for the matter of a chromosome! Can one even call such a person a ‘professional?’ Have they even earned the title? While there is a new trend in helping doctors become more observant by taking art classes, as in the case of medical training at Temple University according to NPR’s BBC World Service, more training in self-awareness, a type of Gestalt-training established by Fritz Perls, who strived for teaching people to reach their core, sticking to the indisputable reality, and shedding their inhibitions and inferiority or superiority complexes, would result in more doctors being ready to admit their own limitations and seeing their patients through the lens of their medical knowledge rather than their personal opinions and hidden biases.

The doctors themselves and their reasoning are the tools of their work. So why is all the training technical? Where is the training or evaluation for interpersonal intelligence?

So I leave you with this — give me a break. There should be no fine script “terms and conditions” to taking care of someone’s life. The year is 2016 (further confirmation of this fact can be found on the front of this paper). We have the means, we have the technology, and the reason we don’t have the diagnosis is a matter of personal preference? In order to rule a condition out, you have to take it into account first and evaluate it before you can determine it not to be a possible factor or a diagnosis. It’s not a matter of pay, nor is it a matter of working overtime. It’s a matter of meeting the patient at a basic level of human-to-human respect and maintaining high moral standards.