Gender Bias: Just What the Doctor Ordered

by Lisa Codispoti, Senior Advisor
and Brigette Courtot,  Policy Analyst
National Women’s Law Center

This post is part of a weekly series on Women and Health Reform.

As good Catholic schoolgirls, we heard it all the time growing up - “Actions speak louder than words.” And a new Canadian study of gender bias among physicians confirms that indeed, what doctors say isn’t the same as what doctors do, and this is a problem. When surveyed, doctors say that a patient’s gender has no effect whatsoever on their decision to refer that patient for a total knee arthroplasty (AKA a new knee). So researchers trained two people—one man and one woman—to act as standardized patients with identical levels of knee osteoarthritis. This pair of patients visited more than 70 doctors, presenting the same set of symptoms (and the same medical history and health status) in exactly the same way, and ending their descriptions with the exact same line, “Do you think I need a new knee?” But doctors’ recommendations weren’t exactly the same for these two patients; it turns out that the male patients were twice as likely as the female patients to receive a recommendation for a new knee (and researchers indicate, by the way, that a new knee is in fact the right treatment decision for a patient with this level of osteoarthritis).

So, let’s recap: Women are a lot less likely to get a highly effective and common surgical procedure, a procedure that relieves the disability caused by arthritic conditions and allows one to participate in everyday activities (like walking) without pain, simply because they are women. Yep, gender bias seems to pop up everywhere, including in your doctor’s office. But it is only one piece of the broader picture of health disparities. There is a growing body of evidence that doctors often treat patients differently based on their race or ethnicity as well. And different treatment results in different health outcomes and differences in overall health status. When we talk health reform, it is important to acknowledge that fixing our health system has to go beyond making sure that everyone has health insurance or comprehensive health benefits, or that we can each get a doctor’s appointment when we need one. Tackling bias in health care is just as important, but perhaps not so easy to address because it requires changes in the way we educate health providers, the diversity of our health provider workforce, and in individual physician attitudes. Addressing health disparities will be challenging, but it must be part of our efforts to assure access to quality, affordable, comprehensive health care for all.