Dr Alyson McGregor is a doctor in Rhode Island, USA. She has recently written a book about how medicine not only appears to treat women differently from men at the point of treatment, but that this is reflected in medical training, research and even testing of medications. In her view, this can lead to many women going undiagnosed or wrongly diagnosed or treated. Her book, she says in an interview with the Observer magazine on 24 May 2020, was written “as a wake-up call” to “educate and empower the rest of us”. She urges women to be “pushier patients”.
Now, we here at Ringrose Law have to have a certain amount of medical knowledge for the job we do as medical negligence and personal injury lawyers, but we are by no means professionally and properly trained doctors, so we do not want you or do we advise you to act on our comments in this article alone. Always take and follow medical advice from those treating you. But we are always open to new ideas – everything has to start somewhere and can lead to radical and important changes in medical treatment that benefits everyone, so the interview article was worth a read.
Dr McGregor says she was asked towards the end of her training what she would like to specialise in. She suggested “women’s health”, but this was immediately taken to be obstetrics and gynaecology. She comments about the jokey assumption that in medicine, women seemed to be seen as “men with boobs and tubes” and that women’s health was seen as mainly concerned with reproduction. But she knew that her interests were far wider than that, and that that “joke” was actually a concern.
Dr McGregor wanted to look at every aspect of health from a holistic women’s point of view.
She realised that the way women were made up – in hormones, tissues, symptoms and structures- impacted on every disease or illness and how it should be treated. It became apparent to her that these differences were just often not taken into account when diagnosing and treating women. You can take this analogy further and say that there are also differences with age, ethnicity and life- style, but Dr Mc Gregor’s book centres on women, so that’s where we’ll stay too.
Two of her most striking examples are that women could possibly be more than 50% likely to receive an initial incorrect diagnosis for a heart attack, because they can present differently and are treated differently for pain. The British Heart Foundation is indeed currently carrying out a 3 year campaign to focus on what it calls the “heart attack gender gap” and with pain, women are more likely to be told their pain is “normal” – they can be perceived as not so much in pain, but worried about it and as a result are prescribed fewer analgesics than men. It appears that women presenting with IBS (Irritable Bowel Syndrome) are more likely to be given “lifestyle advice” than men, who are more likely to be offered an exploratory x-ray.
There are of course too many factors to be taken into account for this short piece to cover- you’ll have to read the book-but one of the reasons could be that historically, women were excluded from medical trials, partly because they were thought more “vulnerable”, but also because they metabolise drugs differently due to hormone and enzyme levels. This can affect “bio-availability” which is the term for the amount of a drug that will actually be utilised by the body and work as planned. These factors could affect both the cost of drug trials and the time they take and drug companies will want to keep both as low as possible. So women are excluded and end up with medication designed for men.
As we have said, we are not medics, so if you have any concerns, then the people to see are your own GP’s or to attend A&E if warranted.
The NHS are keen to stress that other than for non- emergency elective procedures, it is “business as usual” for genuine illnesses and injuries and they don’t want these to be overlooked.
But the book is worth a look for the issues it raises. If change is needed, then we have to start raising those issues. Journeys of a thousand miles starting with the first step and all that…..
Dr Mc Gregor’s book is called “Sex Matters: How Male- Centric Medicine Endangers Women’s health And What We Can Do About It” is published by Quercus at @£16.99