A couple of weeks ago, my mother-in-law went in to an urgent care accompanied by one of her fabulous daughters. Though the provider there was told multiple times that there was a sudden onset of symptoms between one day and the next, the individual involved repeatedly dismissed that and said that it was probably just old age and maybe a UTI. A few days later, when symptoms continued to worsen, my mother-in-law went directly to an ER. Tests were performed, revealing multiple tumors throughout her body and one rather large one in her brain, which had been causing the symptoms noticed. Certainly a delay of a few days in appropriate diagnosis would not have changed the outcome here, but if she had been having a stroke, it most certainly would have.

Many years ago I had a friend who was experiencing abdominal pain. She repeatedly went to her doctor and was told that it was just her weight. After several months of this, she convinced a provider to do a scan, and she was diagnosed with stage 4 ovarian cancer, and sadly, passed away a very short time after that. If her original assertions of pain had been not written off as the effects of being overweight, she may have had treatment options that could have extended her life.

And, many women, myself included, have gone in to receive evaluative care for symptoms to be asked, “Are you sure you’re not just having an anxiety attack?” (or to be flat out told that was what the provider definitively thought was happening) only to be diagnosed with something medical other than anxiety after persisting. Emily and I were speaking about this recently and she said to me, “you know, I don’t really think of you as anxious. I’ve seen you be stressed out, but when you are there’s always something really stressful going on.” Yep.

Ageism. Obesity biases. Sexism in regards to how pain is evaluated and treated. Studies are clear these elements can and do negatively drive outcomes in healthcare. And yet, I know that many providers genuinely care about doing the best they can and are in a really tough spot when it comes to providing care. The current reimbursement model in the US requires super short visits, and it’s not easy to get a comprehensive history in that period of time, and when the human body itself functions as an entire system, treating one symptom as if it’s independent of other areas really doesn’t make good health sense…but time wise, that’s often what everyone is left doing.

But, if the family member or patient asserts something unusual for them really is going on, there is no benefit to withholding tests. The patients or their families are the ones who will be paying for those, after all, and as expensive as things are right now in the US even with insurance, most people aren’t rushing in for something just because they want to waste healthcare resources or their own money. When I was seen in the ER for anaphylaxis this past January, a member of the ED team said to me that if she ever got sick enough to need an ER she’d probably just stay home and die because she couldn’t afford to pay her portion of the bill. So when people are willing to spend the money, I think their reasons should be taken seriously.

What I would want each of you to know right now is that it’s OK to seek a second opinion right away if you feel that a healthcare provider was perhaps dismissing your symptoms due to some sort of “ism” or bias. You (or your insurance for the portion they are reimbursing) are a paying customer. Your willingness to go in for check ups and care is part of what allows each healthcare provider you see to have a job. Yes, medical providers may have healthcare training and education that you don’t, and especially in difficult times like our current ongoing pandemic many of us owe a great deal to the sacrifices made by front-line providers,. But they are also as human and as fallible as any other human. Yes their education and position is absolutely worthy of respect, but so too is your account of what is being experienced.