In the past, women have experienced difficulties in getting the right diagnosis. Statistics have shown that doctors are more likely to misdiagnose men compared to women. For instance, research has shown that women are about 50% more likely than their male counterparts to receive a wrong diagnosis in the aftermath of a heart attack. Despite the medical advancements experienced in the last decade, misdiagnosis remains a significant issue. The question that therefore needs an answer is why women experience disproportional diagnosis. On a keen analysis, women of color are more prone to misdiagnosis compared to the whites. According to a study conducted in New York City in 2016, the result proved that black women were likely to experience severe complications during pregnancy compared to their white counterparts. Several reasons have been implicated in the high rates of misdiagnosis among women including inadequate research, differential symptoms, and the nature of women.
Identification of the Group
The group under study is the women patients experiencing misdiagnosis. The larger culture in which this group exists is that of women patients. The group can be broken down into several parts based on the particular disease they were misdiagnosed for. For instance, women can be misdiagnosed for a wide variety of illnesses affecting reproductive health, cardiovascular infections, and general health among others. Based on the particular nature of the disease, misdiagnosed women can be classified into different groups. An example of a sub-group would be women misdiagnosed for cervical cancer. Several reasons attracted me to this particular group. First, I found it intriguing that women tend to suffer the problem of misdiagnosis more even though most diseases are shared across the gender divide. Secondly, there has been a public outrage on this issue with famous women such as Serena Williams being victims of the problem. Thirdly, my attention was drawn to the matter because it is one of the factors that contribute to the disparity in healthcare. When women are constantly misdiagnosed, their rates of morbidity and mortality will increase.
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The patient experiencing misdiagnosis is a unique group compared to different groups; for instance, women with depression for several reasons. First, misdiagnosed women are at an increased risk because they are likely to undergo treatment for an infection that they do not have. In the process, they will incur unnecessary healthcare expenditures which might be costly. On the other hand, women with depression or any other known condition will receive proper healthcare services including diagnosis and treatment. Since they are backed with evidence-based care, all interventions they will partake will be in line with their healthcare requirements. Membership in this group is involuntary and depends on the effectiveness and professionalism levels in the healthcare industry. It, therefore, means that membership cannot be revoked unless the diagnosis is brought on track and the underlying conditions affecting the patient are determined. The misdiagnosis of women has also been associated with a plethora of stereotypes. Many people, especially the misogynic ones, have intimated that women are naturally weak and introverted;two factors that contribute to their misdiagnosis based on their inability to express themselves fully.
From a broader perspective, members of this group are viewed just like any other patient whose disease has become increasingly difficult to solve. On the flip side, misdiagnosed women view the society as full of inadequacies including resources and knowledge that have led to their condition. Members of this group have received significant attention over the recent past. Most of them have been due to their celebrity status. However, many women continue to experience misdiagnosis, some of which exist in the form of life-threatening errors. Important to note is that this is not a formal group. Members are determined by virtue of the experiences they have in the care setting. Therefore, no rules are present including any formal association. However, the need to create awareness of misdiagnosis among patients has existed for a while. Women are rallying together in the wake of the erroneous treatment to call for a review into some policies. Through legislative actions, for instance, some members of Congress have gone ahead to advocate for laws that will increase funding to facilitate maternal health during childbirth. They remain aware of the fact that this is one of the areas that many women have suffered the impact of misdiagnosis.
Literature Review
Singh et al. (2017) asserts that diagnosis remains one of the most important jobs performed by primary healthcare givers. The authors go on to cite research conducted by a body known as Improved Diagnosis in Healthcare which asserted that individuals would mostly experience a diagnostic error in the course of their life. They define misdiagnosis as an error that happens when "a patient's diagnosis is missed altogether, inappropriately delayed and/or wrong, as judged by the eventual appreciation of definitive information" (Singh et al., 2017). Many of the diagnostic errors experienced reflect the vulnerabilities and complexities in the healthcare system. Shimkhada et al. continue to echo the sentiments regarding the problem of misdiagnosis facing women. Although they believe that misdiagnosis is a significant problem in the healthcare industry, they cite under-recognition as a stumbling block to the formation of viable solutions. Out of all the 5% adult misdiagnoses in the US, a majority include infections include the ones unique to women. For instance, misdiagnosis in women is reported in more than 20% of the cases (Shimkhada et al., 2016).
Many low and middle-income countries have been unable to demonstrate the much-needed accuracy in diagnosis, especially in obstetric issues. Obstetric relates to childbirth and all the other factors associated with it. Research has demonstrated that the misdiagnosis in this key medical area has been responsible for the unprecedented mortality rates among women. Some women sustain complications that affect their fertility thus denying them the opportunity to conceive in the future. Aziz (2014) bases his focus on the impact of misdiagnosis in coronary artery disease. He begins by noting that cardiovascular disease is the main cause of deal among women. Also, it is a leading cause of disability. However, the only problem is that gender differences in diagnosis continue to affect women with the disease. It is in this regards that Aziz, (2014) says, "It has been seen that women experience more complications from diagnostic angiography and have poorer result after angioplasty." It is also common for women to experience complications after undergoing medical procedures such as surgery that accompany the health concern. Some of the complications that arise from misdiagnosis include hemorrhage and heart failure among others.
Several reasons have been postulated as to why women are prone to misdiagnosis compared to their male counterparts. Research continues to show that women are likely to receive misdiagnosis in four critical areas including heart disease, stroke, autoimmune disorders, and pain among others. One of the reasons to explain the misdiagnosis has been down to the differential symptoms. Studies have shown that under the same health conditions, men and women are more likely to have different symptoms. However, the problem is that the doctors and other health professionals are more acclimatized to the male version of the disease. For instance heart attack is recognized by chest pains in men. In women, subtler symptoms such as indigestion, fatigue, shortness of breath, and pain in areas such as jars and the arm are evident. However, when presenting to the clinical setting, there is a possibility that the doctors handling the women will instead suspect flu and stress-like symptoms hence missing the actual diagnosis. Another factor that has been often cited to explain for the widespread misdiagnosis is the lack of research. For many years, scientists have used the male body as the template for medical research. This is despite the fact that the Congress, in 1993, passed a law that required all clinical trials to include women as subjects.
However, this is yet to realize as men continue to be the face of many clinical studies across the world. The stereotypes associated with women have also been implicated in this problem. They are regarded as weak and prone to overplaying manifestations even the ones for normal human conditions such as the monthly periods. For example, it is common to hear a medical practitioner telling a woman with endometriosis that the pain in their periods is normal. Ignorance has also played a significant role especially in situations where the doctor ignores or downplays the assertions by the women patients. An example was seen in the case of Serena Williams which will be discussed later on. More fundamentally, racial discrepancies have also been witnessed in assessing the misdiagnosis of women. Missed and delayed diagnosis has remained a significant problem for the women of color. According to Mulley et al. (2012), research in the US has shown that women of color are more likely to suffer from obstetric complications compared to their white counterparts. Many conditions such as lupus are more prevalent in women of color compared to white women. One of the reasons to explain the disparity is the impact of misdiagnosis and associated medical errors. Fibroids have a three-fold prevalence in the black women population, another disease that is often associated with misdiagnosis especially at its inception.
Literature has also focused on the strategies that women need to take in ensuring that they receive a better and accurate diagnosis in the future. Women need to trust their instincts. They should refrain from downplaying symptoms or hiding their feelings to the doctors. Doctors and allied health professionals treat patients based on their symptoms. Mulley et al., (2012) asserted that without an accurate explanation of the feeling, it becomes increasingly difficult to give the patients the best possible diagnosis and treatment. The women must remain ready to ask questions when receiving interventions such as diagnostic tests and treatments. Asking question keeps the health practitioner in check and focused on the treatment. The patients should also show persistent during the treatment process. The patient should be ready to give the doctor their point of view. When they feel that this is neglected, they should remain persistent and seek a second opinion. As such, this ensures that the doctor remains mindful of the patient's position taking consideration of every little detail that might assist in covering the root-cause of the illness. The onus is also on the part of the medical practitioners and the broader medical care industry. Misdiagnosis and diagnostic errors qualify as unethical practices.
Doctors and nurses have an obligation to provide the best care to their patient. Diagnosis is a fundamental step in the process of treatment and can be the make or break point of the entire process. Therefore, in this regard, health workers must respect the ethical principles such as informed consent, disclosure, autonomy, and integrity in ensuring that they mitigate all the loopholes that could allow the entry of errors. Misdiagnosis can also result from factors that are beyond the capacity of the health practitioners (Mulley et al., 2012). With the emergence of many diseases and the mutations, there is a need to come up with sophisticated technology that will play a critical role in the uncovering of the diseases. However, many hospitals, especially in developing countries, lack the necessary diagnostic tools to achieve this. As a result, the chances of diagnosis become high. More training and capacity building needs to be done to ensure that the doctors and nurses are at per with the rapid changes taking place in the healthcare industry. With this, a positive diagnosis will rule the healthcare industry.
Examination of Representations
Several cases have been highlighted in the media to depict the extent to which women have experienced the problem of misdiagnosis. One of these stories has focused on Serena Williams, a tennis superstar. The problem she experienced could be classified as an obstetric issue because it involved childbirth. She engaged was forced to undergo a caesarian section which later caused her a severe life-threatening blood clot. However, the fact of the matter is that throughout her agony, she tried to point out to the doctor of her situation, a move that could have kept her away from all the distress she experienced. After receiving the ultrasound test, Williams informed the doctors that she needed a Computer Tomography (CT) scan and a heparin drip. The ultrasound had done little to uncover the blood clots. After the CT scan was done, the doctors were able to find out the blood clots that had settled in William’s lungs (Rueckert & Sepehr, 2018). Although she survived, this was an indictment on the health professionals who fail to appreciate the point of view of the patients, especially in life-threatening circumstances. Had the doctors failed to take into consideration William's plea, then probably she would have died from the situation.
Based on the incident, many interpreted it as a broader manifestation of the implication of race in misdiagnosis. Serena Williams is an African American woman. Black mothers have been victims of obstetric health. Statistics point out that “black mothers are 243% more likely than white mothers to die from pregnancy or complications related to childbirth in the United States” (Rueckert & Sepehr, 2018). The case of Serena Williams received widespread attention based on her status as a famous tennis player. However, the reality is that many black women continue to experience incidences of diagnosis not only affecting their reproductive health but also other aspects. The news outlet continued to provide research studies proving that black women are disproportionally affected by the problem of misdiagnosis. According to the article, the mortality rates in New York City are 12 times higher for African American women (Rueckert & Sepehr, 2018). It thus shows that the problem of misdiagnosis has deeper roots than was ever thought. Racial segregation and prejudice continue to have a significant impact on the effectiveness of treatment for these women. As a result, women of color report poor reproductive health and are more likely to die as a result of the complications.
The lack of seriousness and ignorance by the medical practitioners has also proven to have significant implications on the course of treatment. In a long Instagram post, Selma Blair, an actress, revealed that she had been diagnosed with multiple sclerosis. The diagnosis was only received recently despite many years of suspecting it. However, according to her, the problem was never taken seriously by those charged with her health. According to Blair, she believes that she has had the disease for at least 15 years. Multiple sclerosis is a disease that affects the central nervous system. It primarily targets the transmission of nerve impulses as reported by the National Multiple Sclerosis Society. As such, it could result in tremors, fatigue, dizziness, numbness, and the weakening of the limbs. Statistically, Hendricks (2018) asserted that the disease affects up to 2.3 million people worldwide. Also, the condition is more prevalent in women as compared to men. However, the illness has high rates of misdiagnosis. A recent study conducted in 2017 by Health Union revealed that 42% of the people living with the infection had initially been diagnosed with a different condition (Hendricks, 2018). Some of the diseases most commonly confused with multiple sclerosis include migraine, depression, and fibromyalgia.
It, therefore, means that Blair will now have to live the rest of her life with the condition. She took the opportunity to thank the producers, actors, and crew for giving her a supportive environment as she deals with the disease. She recounted some of the symptoms she had including a feeling of disability and foggy memory. The only regret she has is that the disease could have been identified much earlier. Despite her efforts to alter the medics that she was suffering from the infection, she was ignored continuously and given treatment for something she did not have. However, multiple sclerosis does not have any known cure. However, the symptoms can be managed through physical therapy and medications to enhance strength. From a broader perspective, the case primarily reveals two things. First, some misdiagnosis emanates from circumstances that are beyond the scope of the medics. Multiple sclerosis is a rare disease and is therefore bound to be misdiagnosed especially during its initial stages. Secondly, the need to listen to the patients remains critical in ensuring a proper diagnosis of the patient. Constantly ignoring them is not only unethical but also unprofessional for the healthcare industry.
Conclusion
Misdiagnosis remains a significant problem that has far-reaching consequences on the well-being of women. The problem has been well-documented in the research studies as well as in literature. The findings show that women are in are more likely to be misdiagnosed compared to me for several reasons some of which are due to inadequate research and prejudices. It is also essential to appreciate the fact that a majority of the misdiagnosed conditions are life-threatening including heart disorder and obstetric gynecology among others. It is therefore incumbent upon the healthcare industry to take responsibility and set mechanisms that will enable accurate diagnosis of patients. Some of the measures include allowing free expression of patients, undergoing training, and remaining technological astute. The problem has also been associated with racial connotations as witnessed in research which states that women of color are more likely to be diagnosed compared to their white counterparts. Lastly, misdiagnosis as a problem for women has received immense media attention as described in the case of Serena Williams and Selma Blair. Both are stars in the tennis and movie industry respectively. It, therefore, shows that everybody is in danger of this problem and the necessary steps should be taken to minimize the incidences.
References
Aziz, F. (2014). Coronary artery disease in women: an unsolved dilemma. Journal of clinical medicine research, 6(2), 86.
Shimkhada, R., Solon, O., Tamondong-Lachica, D., & Peabody, J. W. (2016). Misdiagnosis of obstetrical cases and the clinical and cost consequences to patients: a cross-sectional study of urban providers in the Philippines. Global health action, 9(1), 32672.
Singh, H., Schiff, G. D., Graber, M. L., Onakpoya, I., & Thompson, M. J. (2017). The global burden of diagnostic errors in primary care. BMJ Qual Saf, 26(6), 484-494.
Mulley, A. G., Trimble, C., & Elwyn, G. (2012). Stop the silent misdiagnosis: patients' preferences matter. BMJ, 345, e6572.
Hendricks, S. (2018). Selma Blair Reveals MS Diagnosis after Years of Not Being “Taken Seriously” Refinery29 https://www.refinery29.com/en-us/2018/10/214684/selma-blair-multiple-sclerosis-instagram
Rueckert, P. & Sepehr, J. (2018). Serena Williams’ Scary Childbirth Story Is Part of a Larger Pattern of Discrimination Against Black Moms. Global Citizen https://www.globalcitizen.org/en/content/serena-williams-childbirth-discrimination/
