Many women report being ‘dismissed’ by doctors. The problems extend far beyond the exam room

One-third of women in the United States have struggled to get doctors to take their symptoms seriously, according to a new survey. And of those women, more than half said their health issues have affected their work and homelives.

Many Americans have inadequate access to quality healthcare, said Stephanie Marken, a researcher who worked on the survey, which was released Friday by Gallup and the organization Pivotal. But for many women, getting an appointment is “really half the battle.”

Once they have seen a provider, “they’re having a series of negative experiences at a much higher rate than men — things like feeling like they’ve been dismissed, or that their pain has been minimized, or that they’re leaving without the information that they need,” said Marken, a senior partner at Gallup.

Lingering health issues translate into missed opportunities at work or less time and energy for family, said Renee Wittemyer, a vice president at Pivotal, which was founded by philanthropist Melinda French Gates to advance social change for women.

The survey results show “ the barriers women face in accessing healthcare , and how often those become barriers to opportunity, keeping them from living the lives they want,” Wittemyer told CNN.

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What women can do to prioritize their health. A doctor explains

The survey asked 5,200 adults in the United States whether they had encountered any of four negative experiences with healthcare professionals in the past five years: feeling dismissed; receiving a misdiagnosis or no diagnosis; not getting clear answers or instructions; or getting conflicting advice. (Healthcare professionals could include doctors, nurses, physician assistants or other workers in a medical setting.)

More than half of women — 51% — said yes, compared with 39% of men. The most common complaint, reported by one-third of women, was that providers minimized or dismissed their symptoms or pain.

The disparity didn’t surprise Dr. Kimi Chernoby, an ER physician in Virginia. “We have a history of gender bias and not believing women,” said Chernoby, who is the chief legal officer of the FemInEM Foundation, a nonprofit that works to improve gender equity in emergency medicine. “Then we have surveys like this and no one should be shocked.”

A common tendency is to assume women are being dramatic or exaggerating when they describe symptoms of pain and discomfort, said Sahnah Lim, an associate professor at NYU Grossman School of Medicine whose research focuses on women’s health equity: “This has been going on for centuries.”

When medical professionals don’t heed their patients’ concerns , the consequences can be frustrating, dire or even deadly.

For instance, severe bleeding after giving birth, called postpartum hemorrhage, is one of the top causes of maternal mortality in the United States. The condition is preventable, but providers often don’t heed women’s initial reports of symptoms.

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Healthcare providers also often miss heart attacks in women because they don’t present with the telltale chest pain that men do.

In the poll, women were far more likely than men to report fighting to have their health concerns taken seriously: 42% of women said they have had to speak up or advocate for their health, compared with 26% of men.

What’s more, men were diagnosed faster than women — even when they had the same medical condition.

Chernoby noted that it can sometimes be difficult for providers to reach a diagnosis, especially for pain syndromes and mental health conditions that can’t be objectively tested for.

“Then it becomes a question of, ‘Do you believe the patient in front of you?’ And the default for all of us should be, ‘Yes,’” she said. “But unfortunately, for a myriad of reasons, including the history of medicine and innate gender bias that permeates our medical system, it’s often not the case.”

The potential fallout from a misdiagnosis or missed diagnosis can be catastrophic. The repercussions can also be subtle and insidious.

“Women are experiencing a very different healthcare system than men,” Marken said. “That’s having a significant impact on every aspect of their lives.”

Both men and women who said a provider had minimized or dismissed their symptoms were far more likely to report that their health has kept them from doing everything they wanted to in life.

Overall, though, women more often than men said their health issues have had a negative impact on their family, social lives or career. Of f emale respondents, 42% said their health has limited their work in some way in the past five years.

That finding was “pretty jarring,” Wittemyer said via email. “Just picture your own workplace and what it would mean if four in ten of the women there felt they had to work fewer hours or couldn’t pursue a promotion or new opportunity because of their health. That’s the reality.”

The figure was highest among Black women (49%) and Hispanic women (45%).

The way patients write messages to doctors might affect the response

To the millions of women who feel that medical professionals aren’t listening to them, Marken said, “Keep pushing.”

Dr. Wendy Harpham, whose new book, “Clinical Communication: Finding the Best Words to Inform, Comfort and Motivate Patients,” offers advice for how clinicians and patients can work together, said it helps to come to each appointment prepared with a list of questions and concerns to discuss.

Write it on a piece of paper or your phone, with the highest priority items at the top. Think through how you’ve been feeling so you can summarize your situation succinctly and efficiently in the limited time you have.

“It has to be a team effort for the doctor to get the information they need and for the patient to be heard,” she said.

If you’re at an impasse with your doctor, she said, it’s OK to cut ties and find someone you’re more comfortable with. Chernoby concurred, urging women to trust their instincts. “If something doesn’t sit right, get a second opinion,” she said. “People know their bodies. They know when something is wrong.”

But, the experts agreed, the onus shouldn’t be on women alone to fight for attention in a medical system that’s supposed to be taking care of them.

“It’s really not their issue. It’s a system issue,” Lim said. “There’s only so much advocacy one person can do for themselves.”

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一项最新调查显示，美国有三分之一的女性难以让医生认真对待她们的症状。在这些女性中，超过半数表示她们的健康问题影响了工作和家庭生活。

参与盖洛普和Pivotal机构周五发布的这项调查的研究员斯蒂芬妮·马肯表示，许多美国人无法充分获得优质医疗保健服务。但对许多女性来说，预约就诊“实际上已经成功了一半”。

盖洛普高级合伙人马肯表示，女性在就诊后，“比男性更容易遇到一系列负面经历——比如感觉自己被忽视，或者感觉自己的痛苦被轻描淡写，或者感觉自己离开时没有得到所需的信息”。

Pivotal 副总裁 Renee Wittemyer 表示，持续的健康问题会导致工作机会的错失，或者减少陪伴家人的时间和精力。Pivotal 由慈善家 Melinda French Gates 创立，旨在促进女性的社会变革。

维特迈尔告诉 CNN，调查结果显示了“女性在获得医疗保健方面面临的障碍，以及这些障碍如何经常成为她们获得机会的障碍，使她们无法过上自己想要的生活”。

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女性可以采取哪些措施来优先考虑自身健康？一位医生解释道。

该调查询问了美国5200名成年人，在过去五年中是否遇到过以下四种与医疗保健专业人员相关的负面经历：被忽视；被误诊或未确诊；没有得到明确的答案或指示；或得到相互矛盾的建议。（医疗保健专业人员包括医生、护士、医师助理或其他医疗机构工作人员。）

超过半数的女性（51%）表示同意，而男性这一比例为39%。三分之一的女性反映，最常见的抱怨是医护人员轻视或忽视了她们的症状或疼痛。

弗吉尼亚州急诊科医生基米·切尔诺比博士对这种差异并不感到意外。“我们一直以来都存在性别偏见，不相信女性，”切尔诺比说道。她是FemInEM基金会的首席法律官，该基金会是一家致力于改善急诊医学领域性别平等的非营利组织。“所以，当我们看到这样的调查结果时，任何人都不应该感到惊讶。”

纽约大学格罗斯曼医学院副教授 Sahnah Lim 的研究重点是女性健康公平，她说：“人们常常倾向于认为女性在描述疼痛和不适症状时是在夸大其词或小题大做。这种情况已经持续了几个世纪。”

当医务人员不重视患者的诉求时，后果可能令人沮丧、极其严重，甚至危及生命。

例如，分娩后严重出血（称为产后出血）是美国孕产妇死亡的主要原因之一。这种情况是可以预防的，但医护人员往往忽视女性最初报告的症状。

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越来越多的女性从未接受过宫颈癌筛查。以下是相关风险。

医疗机构也经常漏诊女性心脏病发作，因为女性不会像男性那样出现明显的胸痛症状。

民意调查显示，女性比男性更有可能表示她们曾努力争取让自己的健康问题得到重视：42% 的女性表示她们不得不为自己的健康发声或争取权益，而男性这一比例为 26%。

此外，男性确诊速度比女性快——即使他们患有相同的疾病。

切尔诺贝指出，有时医疗服务提供者很难做出诊断，尤其是一些疼痛综合征和精神健康问题，这些问题无法进行客观的检测。

“那么问题就变成了，‘你是否相信眼前的病人？’我们所有人的默认答案都应该是‘是的’，”她说。“但不幸的是，由于种种原因，包括医学史和根深蒂固于我们医疗体系中的性别偏见，情况往往并非如此。”

误诊或漏诊可能造成的后果不堪设想，而且其影响可能十分隐蔽和难以察觉。

“女性所处的医疗保健体系与男性截然不同，”马肯说。“这给她们生活的方方面面都产生了重大影响。”

无论是男性还是女性，如果表示他们的症状被医疗服务提供者轻描淡写或忽视，他们就更有可能表示自己的健康状况使他们无法做生活中所有想做的事情。

总体而言，女性比男性更常表示她们的健康问题对家庭、社交生活或事业产生了负面影响。在受访女性中，42%的人表示，过去五年里，她们的健康状况在某种程度上限制了她们的工作。

维特迈尔在电子邮件中表示，这一发现“相当令人震惊”。“试想一下你自己的工作场所，如果十分之四的女性因为健康原因不得不减少工作时间，或者无法追求晋升或新的机会，那意味着什么？这就是现实。”

黑人女性（49%）和西班牙裔女性（45%）的比例最高。

患者给医生留言的方式可能会影响医生的回复。

马肯对数百万感觉医务人员不听她们说话的女性说：“继续努力。”

温迪·哈普汉姆博士的新书《临床沟通：找到最佳措辞来告知、安慰和激励患者》为临床医生和患者如何合作提供了建议。她表示，每次就诊前准备好要讨论的问题和疑虑清单会很有帮助。

把它写在纸上或手机上，把最重要的事项放在最前面。仔细想想你的感受，这样你就能在有限的时间内简洁高效地总结你的情况。

她说：“医生需要付出团队努力才能获得所需信息，病人也需要得到倾听。”

她说，如果你和医生之间陷入僵局，断绝关系，找个让你更放心的医生也无妨。切尔诺贝对此表示赞同，并敦促女性相信自己的直觉。“如果感觉不对劲，就去寻求第二意见，”她说。“人们了解自己的身体。他们知道什么时候出了问题。”

但专家们一致认为，不应该仅仅由女性独自承担在医疗体系中争取关注的责任，因为医疗体系本应照顾她们。

林说：“这真的不是他们的问题，而是体制问题。一个人能为自己做的倡导工作毕竟有限。”

每周精选健康生活小贴士，助您轻松享受美好生活。订阅 CNN 的“生活更美好”电子报，获取提升幸福感的资讯和实用工具。