Emergency room doctors take women’s pain less seriously than men’s, new study shows

Age-old biases are steering pain treatment in emergency rooms, a new study found.

Published Aug. 5 in the journal Proceedings of the National Academy of Sciences, the study explains that women are less likely to receive medication than men who report the same level of pain.

“Our research reveals a troubling bias in how women’s pain is perceived and treated in emergency care settings,” researcher Shoham Choshen-Hillel said in an Aug. 7 statement.

Essentially, pain care depends on the patient’s sex, according to the study.

Researchers analyzed hospital discharge papers from over 21,000 patients in the U.S. and Israel who had gone to emergency rooms complaining of pain between 2014 and 2019.

Study authors discovered that the disparity in pain medication prescriptions was ubiquitous, regardless of the sex of the practitioner.

Researchers also found that female patients spent an average of 30 extra minutes in the emergency room compared with males.

It is common for doctors and nurses to ask patients to rate their pain on a scale of 1 to 10. The study revealed that female patients’ pain scores were 10% less likely to be recorded at all.

The undertreatment of female pain in health care is part of a long-standing societal issue of women’s pain being downplayed or dismissed, the scientists said.

Stereotypes of women as overly sensitive or dramatic has bled into medicine, researchers say, and has been well-documented.

Academics call it the gender-pain exaggeration bias, wherein health care workers are likely to assume that female patients are exaggerating their discomfort, researchers said in a 2023 study.

In 2001, researchers at the University of Maryland published “The Girl Who Cried Pain,” a 15-page report whose title is a nod to folklore’s most famous faker.

The authors analyzed data going back to the 1970s, finding that though women report chronic pain more often and more intensely than men, their pain is far more likely to be dismissed as emotional or psychological.

Like the researchers in the Aug. 5 study, they too found that women’s pain was taken less seriously than men’s, as women back then also received less aggressive treatments for their pain than their male counterparts.

In the 19th century, “hysteria” was a catch-all diagnosis for women who reported any discomfort doctors couldn’t explain. The presumed cure for the female-specific “condition” was simply getting married and having children, according to the Yale School of Medicine. MDLinx, an online health care publishing company, says while biases stretch back further than this, the medicalizing of hysteria helped to normalize the dismissal of women who reported physical pain.

This error in medicine “cast a long shadow” under which many women still find themselves, the company says.

The researchers in the new study said they hope to bring these embedded and unconscious biases to light.

When it comes to the vagueness and subjectivity of pain, “healthcare providers must heavily rely on their perception of the patient’s pain, and so a biased perception is likely to lead to bias in pain management decisions,” the Aug. 5 study said.

For a disparity this systemic, policy may be an appropriate intervention, the scientists argue. Without immediate change, the ongoing issue could lead to more dire problems, researchers say.

“This under-treatment of female patients’ pain could have serious implications for women’s health outcomes, potentially leading to longer recovery times, complications, or chronic pain conditions,” Choshen-Hillel said.

This story was originally published August 9, 2024 at 4:55 PM with the headline "Emergency room doctors take women’s pain less seriously than men’s, new study shows."