How Writing Can Improve Gender Equity in Healthcare
50% of women believe gender discrimination in healthcare is a serious problem. From patients to their providers, women in the healthcare system are faced with not being taken at face value and falling behind their male counterparts.
Simply put, gender inequity is rearing its’ head in medicine because it’s an issue that’s much broader than how patients are treated or how their providers experience their careers. Today, we’ll focus on healthcare, specifically, and talk about what writers can do to help – if only a little bit.
How Does Medical Education Contribute to Gender-Based Inequality?
While medical education isn’t the only factor that contributes to how your doctor treats you, or if you even get that woman OB/GYN you asked for, it’s one of the factors that medical educators have control over.
Every class of medical students brings different genetic and environmental backgrounds into the classroom. From there, it’s in the school's hands to build a culture of ‘gender awareness’, as outlined by Verdonk et al.
In a 2009 study that remains relevant to many of the inequities patients face when they go in for treatment, Verdonk and her colleagues outlined four factors that built cultures of gender being outright ignored.
Medicine has historically called itself ‘gender blind’(something I’m sure any woman who has experienced childbirth would disagree with).
Medicine is said to be ‘male-biased’ because most knowledge about health and illness draws from male experience. (Have you ever seen a diagram of the lungs in a female body? Most ‘anatomical human’ drawings in textbooks are of men.)
Gender role ideology is believed to influence health outcomes negatively.
Gender inequality has been overlooked as a determinant of health and illness.
The study then addresses how to remedy these issues, citing the “dissemination of literature and other educational material” as a key aspect of sparking change in how medical schools teach medicine.
It’s funny, isn’t it, that a profession that has historically claimed gender blindness still has a pay gap?
While this article will center on patient treatment experiences, many of the gender equity conversations in medicine center around providers. 40% of women will go part-time or leave their medical careers within six years of residency. As a JAMA study showed, this can be because of sexual and gender-based harassment, the pay gap, and unfair treatment by male colleagues.
However, it’s most strongly correlated with women having families. Sadly, there’s no safety net for these women. By the time they return to the hospital, they may have lost career progress(salary-wise, promotion-wise) compared to their male colleagues.
Many women will fight tooth and nail on this, saying motherhood is their priority. And that’s an individual choice to make. It’s not an individual issue; it’s a systemic one. A woman should be allowed to leave her career to support a family and return without losing progress. No one should be forced to choose between a career they put over a decade of their life into and their family.
So, where do writers fit into this picture?
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What Writers Can Do to Change the Narrative
Well, we can raise awareness. Speaking specifically to patient experience, though, there’s a lot we can do. Who creates educational materials for medical schools? Realistically, it is usually a conglomeration of organizations like the AAMC that provide materials to help students pass the AMCAS or COMLEX.
Okay, so there is not a lot we can do there. Unless:
You work for the AAMC, or you’re a curriculum writer
You’re an educator
CME Writing & Regulatory Documents
But when it comes to continuing medical education, there’s a little more we can do. At least, that’s the hope I’m holding out for. Big picture, medical education is highly regulated. Medical everything is pretty highly regulated. However, if you’ve been around here long enough, you know I believe that a small group of dedicated people can change the world.
While big organizations can provide CME(continuing medical education) materials, individuals can too! I know - I work with someone who teaches people how to write CME materials. Cool, right?
As CME writers, you’re responsible for designing and writing a curriculum to ensure healthcare practitioners are current with current best practices for their patients. And I think that includes gender equity, don’t you?
Ideas like:
Black women are not more tolerable of pain
Not all women who come in complaining of abdominal pain are pregnant, especially if they’ve told you they probably are not pregnant
Women are more susceptible to certain types of cancer(same for men)
Heart attack symptoms look different in women than in men
This extends to medical writers like those of you who are grant writers and clinical trial oversight writers who have the joy of putting regulatory documents together.
Are there inherent gender biases in the studies you’re writing about that are worth mentioning?
If you’re writing a grant proposal to request more funding for neuroblastomas, have you left out a key piece of information that this occurs mainly in women with severe endometriosis? (I made this up as an example).
My point being, writers do have a role here. Medical writers can influence how doctors adapt to the evolving demands of practice, how they continue to learn to work in teams together, and how they treat each other and their patients.
There is so much more that goes into gender equity for patients and providers than CME writing or examining the bias in the medical or research documents we’re writing.
However, to pretend that medical writing that directly affects health outcomes or documents that influence what research gets funded has no role in gender equity in healthcare is to be as gender-blind as medicine has been.
Patient Education
Another way writers can make an impact is through patient education materials - arguably, my favorite type of medical writing.
It’s important to consider what biases we bring to patient education materials, collectively and individually. Those will inform what we write, and what we write will be read and viewed by real people looking for answers on Google about what their symptoms mean.
When I write patient education materials, I find it helpful to imagine myself as the patient. What would I do if I read this? Would I go to the hospital? Would I tell myself I’m overthinking my symptoms?
Patient education is a fine line between saying,’ play it safe’ and ‘don’t come to the hospital for a stubbed toe.’ It’s a balancing act between mentioning identity factors that put you at risk for diseases without lacing those mentions with emotion or a sense of responsibility.
Patient education delivers facts compassionately, assuming the reader is a wise adult. How you write can impact how people view themselves, their power over the situation, and their understanding of the situation in the first place.
Now You Can Write for the Future You Want to See
That’s a bit cheesy, but I hope you do write for the future you want to see. I hope you check your biases frequently and keep an open mind. Your writing can make a difference for patients and even teams of providers. You may not see the tree grow tall in your lifetime, but you can plant the seed now.
If you’re a healthcare provider or someone in the health & medical sphere needing unbiased health and medical writing that can effectively communicate up-to-date topics and norms, contact me for a chat. I can’t wait to meet you.