Doctor Reacts to John Oliver | Last Week Tonight: Bias in Medicine

– Hey, guys! Welcome to another episode
of the “Wednesday Checkup”. John Oliver just did a
hard-hitting piece on medical bias and you asked me to talk
about it, so let’s get to it. (smooth hiphop music) I actually like getting these
subjects out in the open ’cause I feel like if we can discuss them honestly, openly, and fairly, we’re gonna make the best impact on the healthcare community, starting right here on
this YouTube channel. So when I heard John Oliver
did a piece on medical bias, I knew I had to watch it. But because he talked
about a lot of studies and used a lot of references, I felt like it was in your best interest and my best interest to first
watch the piece on my own, do the research, check out
the studies he referenced, and then watch it again
with you right now. – Men of medicine. – [Announcer] In every US city and town, there is one house that
everybody knows, the doctor. Available here are the services
of the man who, by law, is privileged to practice the most respected of all professions. – In my family medicine
residency training program, we had 21 residents, 18 were
female, three were male. We actually had a little camaraderie that we were the only
three guys in the program. We made running jokes about it. That type of diversity is
really good for medicine. You could even check out my
“Diversity in Medicine” video which I’ll link down
below in the description. – Not everyone has the same experience when they visit a doctor. – I think I would’ve been
treated completely differently if I had been male. – You’ll hear doctors and nurses like, oh, they’re just exaggerating. – Dramatic. – And not really listening to them because it’s a black person,
but if it’s a white person, it’s just like, oh my
god, this is serious. – It’s true. If you are a woman and/or a
person of color in the US, you may well have a very
different relationship to a healthcare system than a white man. – This is difficult for
me to watch as a doctor. Watching patients talk about
getting poor quality of care from my colleagues hurts
because what I wanna do, what I hope all doctors wanna do, is give each and every patient
the best quality of care without distinguishing
between what race they are or what sex they are, what
country they come from, what language they speak. Medicine is not run by robots, it’s run by doctors who are humans and humans have biases and
they have other issues, they have stressors. I’m not making excuses for doctors. I just want you to be aware of all the things we’re
gonna be talking about throughout this video when it comes to gender discrimination, racial discrimination, the
disparities that exist, why that can happen, and really,
the steps that we’re taking as a medical profession to improve that. – Better to talk at you for
20 minutes about this than me, the whitest of white men. (audience laughs) Look, I get a sunburn
watching the Travel Channel. – John Oliver does a really
good job diffusing the situation by using humor here. Oftentimes, I’ll tell my students if they have the ability to
insert humor into a situation, respectfully, of course,
and not distastefully, they should do it because
patients love that. I’ve been on the cancer ward so many times in so
many different hospitals where the second a moment of
lightheartedness comes in, you can see the patient’s smile light up, especially in the pediatric population. We love to laugh, we
love to have a good time with our patients and they love it too. – Let’s talk about bias in
medicine in two specific areas. First, sex, and then race. And in the words of every
therapist I’ve ever had, let’s start with sex. (audience laughs) Historically, women’s bodies
have always been fraught with judgment and misconceptions. – Mom, can I go swimming with
Peggy tomorrow after school? – No, it’s not a good idea the first two or three
days of your period. You might get chills and catch cold. – Oh, that’s right. (audience giggling) Peggy, of course, I can’t go swimming. You know I’ve got the curse. – Yeah, Peggy! – On one hand, we can look
back at it and laugh and say, oh my god, look at the
things we used to say, how politically incorrect
or how inaccurate is this, but I look back at this and I wanna celebrate the
fact that we’ve come so far, that we’ve made strides in medicine. I feel like if I fast forward
100 years into the future and look back at the things I’m doing now, it would be barbaric. It’s gonna feel like we’re cave people working with rudimentary tools. – Women can still face an uphill battle to get quality healthcare. There are many, many studies showing this. For instance, they found
that women were less likely to be referred for knee
replacements than men. – He’s accurate here. There are really good
quality studies that show there are disparities
for women in healthcare. When a disparity occurs, it means something’s
happening on unequal terms. Essentially that’s a correlation, that we see these two events
happening on unequal terms, but we don’t have a causation, meaning we don’t have a
reason why that happens. For that knee replacement
study that he talks about where women are less
likely to get a referral to get a joint replacement, that’s true. This study does exist, it
was was published in 2011 in a good orthopedic journal. They do such a fantastic job analyzing each part of the system. When the patient
recognizes their symptoms, how long it takes them
to go to the doctor. Once they go see their
primary care doctor, what’s the discussion like? How likely are they to get a referral? At what point do they
actually need the referral in terms of the damage that needs to be done to their joints? Once they see the orthopedic surgeon, how likely are there to actually
go for joint replacement? Now, in almost all these cases, they found women were
getting less care than men. I’m gonna quote the study here: “One factor may be the way
patients describe their symptoms. “Women tend to speak more openly “and personally about their symptoms “and describe them in a narrative style, “when compared to men who
typically present their symptoms “in a business-like or factual manner “and are more reserved in their comments. “Women’s narrative presentation
style reportedly contributed “to physicians making
more diagnostic errors.” And this study gives so many factors, both from the patient’s
side, the doctor’s side, the system’s side, all of
these things can be addressed. – If they’re over 50 and critically ill, they were less likely to receive
lifesaving interventions. – The study itself actually
gave some really good points on what we should be doing to correct this because, again, it didn’t specify that this is solely a result of bias. The study talks about the need
for sex or gender analysis after conditions happen, after mortality. We talk about the need for more research to figure out if biases exist and what types of biases exist. And finally, looking at sex disparities that occur between certain conditions. How often do females versus
males have pneumonia? How often do they have
complications of pneumonia? “There may be also plausible
biological explanations “for the differences in mortality “we found between critically
ill older men and women. “Sex has been found “to influence the expression, progression, “and outcome of many
common medical conditions “and can influence pharmacokinetics, “which is how medicine is absorbed, “how it functions, and
responds to therapy.” Now, it may seem that I’m trying to find other reasons than
bias as to why this happens. That’s true to a degree. I wanna make sure that
we’re not missing anything and just jumping to the
conclusion of discrimination because we can then
miss some systemic flaws and biological differences
that had we addressed them, we can do better by our patients. – When going to the ER
with urgent abdominal pain, women were less likely to
receive any pain medicine. – This pain study is actually real. Women were less likely
to get opioid medications than their male counterparts and on average took them longer
to get these medications. But again, the study that
Jon Oliver mentions here, I took a deep dive into it. They do not have a causal
reason for why this happens. They postulate seven reasons. One is maybe doctors are
unaware of women’s biology. They’re worried about masking specific types of abdominal pain that if they treat the
pain, the patient leaves and then something bad
happens to the patient, they’re gonna be doing
the patient a disservice. I think one of the very interesting
points within this study that I like to figure
out an explanation for is that while there
was a gender difference in the prescription of opioid medications for pain between men and women, there was no gender
difference in the receipt of nonopioid analgesia for men and women. If we’re postulating that we
have a gender discrimination occurring here between males and females, why isn’t it hold true
for nonopioid medications? I don’t have the answer to that. That’s why I like that
we’re talking about this and creating avenues for further research. What I want you to know,
this is for the bright side of this conversation that
Jon Oliver doesn’t focus on, ’cause that’s not what
his segment is about, but it’s that we are aware
of these disparities now. Because of this great research that has been done 10, 15 years ago, we are now talking about this. We have bias education in our classrooms, we have different ways we screen female patients
versus male patients because of their atypical presentations. That’s actually one of the next points he’s about to get into. – A lot of times, women’s
symptoms, especially pain, are attributed to emotional imbalance or women being hysterical or
crying wolf about their pain and that’s absolutely wrong. – It’s wrong, flat-out wrong. That’s not the way we’re
trained to practice medicine. I feel like it’s almost an archaic way of practicing medicine. And I think this newer
generation of doctors that’s been trained
within the last 10 years, I hope, and I am optimistic
that the future studies that are gonna be done on
this will show an improvement. – There was also a systemic problem here where doctors may literally
know less about women’s bodies because historically, medicine
has studied men’s bodies which here means those
assigned male at birth as a proxy for all bodies. – He is so right in this case. These studies that have
been done 20, 30 years ago on specific ailments have
been so poorly designed when it comes to the patient population that it’s just not applicable to everyone. Taking care of a female patient is different than taking
care of a male patient. They way they present is different, the way they talk about
their symptoms is different, their biology is different,
their anatomy is different, their hormones are different, and the way they experience
pain is different. This is not a bad thing, it’s just something we need to be aware of and structure our
research around properly. – Take heart attacks. You’re conditioned to think of them looking like they do on TV all the time. People grabbing their chest
and then falling over. But for many women, that
is not what they look like. – The reality is we’ve
studied heart disease as a disease of men. It’s not the case. Women have high rates of heart
disease just as much as men, if not more in some cases because it’s missed and undertreated. – If you are suffering a heart attack, will you always get a shooting pain down your left arm first?
– It’s not always. And in fact, the tricky part about this is men and women feel
heart attacks differently. – Wow!
– The classic symptoms that we see in men is that pressure, the elephant sitting on your chest. They don’t often happen to women. They have more substernal
pain, maybe a discomfort, sometimes radiating to the
jaw instead of the arm. – Your jaw? – Yes. – So you could be thinking
it’s a toothache– – Exactly!
– And you’re literally having a heart attack?
– Yes. – But here’s the good part. Right now in medical school, and even when I trained in
medical school and residency, we’re aware of this because of the quality of research he talks about. We’re so aware of it that now when a patient
comes into my office, a female patient, and has
some of these symptoms, right away, I recommend to the patient, let’s check out your heart and make sure that it’s not your heart. Now, this doesn’t apply to
the entire medical field because there is doctors
that are practicing that are 67 years old
that weren’t taught this. So as time goes on, I think
we’re gonna continually improve our identification of
women’s heart disease, the way we do research. – The young doctor came
in, very condescending, thought I was just a
drama queen, and he said, “It’s not my job to tell
you what’s wrong with you, “it’s my job to tell you what it’s not. “And it’s not your heart.” – That’s obviously an
egregious medical error and horrible treatment of a patient. If you’re going into medicine and you’re gonna be talking
about patients that way, it’s just a failure on
all sides of the equation. Because the goal of a doctor
is to treat the person that’s sitting directly or
laying directly in front of them and to come in and say something
like that, it’s horrible. And I’m sorry that this
patient had to go through that. I don’t wanna poison the
doctor-patient relationship thinking that this is the norm. This is not the norm. – One study found that women who came to the hospital
with heart attack symptoms was seven times more likely
than men to be misdiagnosed and sent home from the
hospital which is terrible. – The tricky part about
recognizing heart attack symptoms in female patients is
that they are often masked and they all often present atypically. Now, we should be on the lookout for this and I do think that if we
repeat these same studies 20 years from now, we’re gonna
have much better outcomes because we’re learning about this. Actually, the American Heart Association has put forth a ton of effort and money into educating the public
about women’s heart health. I actually participated with the American Heart Association Go Red for Women events all the time because we need to not
only educate doctors about keeping their eyes open and being really attuned
to the possibility of these atypical symptoms, but also educate patients themselves. In fact, a Wall Street Journal article that Jon Oliver quotes says this: “Women do bear some of the responsibility “for delays in care themselves. “Women think, ‘Yes we’ll call the doctor “after we pick up the kids
and finish that report “and put the casserole in the oven.’ “But she urges others
to pay more attention “to their bodies and their instincts. “‘You know when something is not right. “‘That’s what I didn’t pay
attention to.’ says Ms. Thomas. “The acid test, if somebody that you love “is experiencing these
symptoms, what would you do?” This is great advice. The thing that I tell my patients is to be alert but not anxious. You don’t wanna be anxious
about your conditions because that can exacerbate
symptoms, make things worse. But if you’re alert and you’re attuned to what’s normal for you, you can then go and talk to your doctor and have a good quality conversation about whether you need to
activate the triage system and go to the ER or you can take the time and go to the urgent care center or your family medicine doctor
appointment a few days later. – We found over 83, 000
excess deaths per year in the African-American community alone. – [Narrator] 83,000
excess deaths each year. That’s the equivalent of a major airliner filled with black passengers
falling out of the sky every single day every year. – Okay, that’s such a weirdly
specific way to put that. – Jon Oliver’s a funny guy. This is interesting. That interview from the
documentary happened in 2008 and it’s amazing how much
socioeconomic factors decide whether or not you’re gonna have good health outcomes. In fact, it’s been said that
social determinants of health, basically your zip code, decides more about your health outcomes, how long you’re gonna live, what quality care you’re gonna receive, moreso than your actual genetic makeup or your medical history. And that’s crazy to think that just because of where you were born, you’re gonna have worse health outcomes. But it’s true. In 2008, that study was
done and that was the case. I will say, in 2017, which is nine years after
that documentary was done, the CDC released a statement saying that the racial mortality gap is closing. Fast forward to 2019, The
Economist releases an article that states Black men in America are living almost as long as white men. Now, that’s a weird headline to hear but it shows that this
racial mortality gap is closing further. Now, we need to keep monitoring this because that can change really quickly depending on the financial
status of the US, how medical care is distributed, insurance status, and all of that, but progress is being made and I think that is the one piece that’s missing out of Jon
Oliver’s segment here, which, I guess, it’s not his
job to give you all of that but it’s that we are making progress. – Even just when it comes to contact with the healthcare system, there can be appalling disparities. There are, again, many studies
showing African-Americans have a lower likelihood of receiving recommended
care for everything from pneumonia to hip
fractures to multiple cancers. – This is one of the things I hate hearing about our healthcare system, that just because you
live in a specific area that has a high amount
of African-Americans or even other minorities, you’re gonna have worse outcomes in care when it comes to pneumonia,
trauma, all of these issues. We’re failing, right? We’re failing as a healthcare system, we’re failing as a nation. And I actually dove into this article that he’s talking about here. “Despite the overall
improvement in outcomes, “the gap in quality of care “between black and white
trauma patients in Pennsylvania “has not narrowed over the last 10 years.” This was a study that was done in 2013. “Racial disparities in trauma “are due to the fact that black patients “are more likely to be treated
in lower quality hospitals “compared with whites.” Just because of the
lower quality hospital, African-American patients are
suffering more complications, having worse outcomes,
receiving worse care? That’s horrible. Is it because these
hospitals are understaffed? Is it because they have
too much patient volume? Meaning too many patients are
coming in at the same time? Is it because they’re not
following the standard protocols? Unless we take a hard, firm stance and look at this data that may
be uncomfortable to look at, we won’t be able to deliver quality care to all types of patients,
irrespective of where they live. – As a study of med
students and doctors found just three years ago, misinformation about
African-American patients is rampant. – [Reporter] The study
found some doctors believed there are biological differences
between the two races. – The way that this newscaster is presenting the information, it’s almost as if she’s
saying doctors are wrong to believe that there are
biological differences between the races. There are biological differences and it’s actually really
important for healthcare providers to be aware of these differences to deliver better healthcare. – [Reporter] 25% of doctor residents thought blacks have thicker skin. – Holy (bleeps)! You do not expect to hear
that at a medical school. You barely expect to hear
it yelled across a table by a racist grandfather at Thanksgiving! – Again, we have to bring
this back into perspective. This study actually presents 15 points, some of which are true
biological differences between black and white patients and it asked medical
students and residents to rate how true those questions were. It wasn’t a yes-or-no question. In taking a test like this,
you’re bound to make mistakes. I would have made mistakes on this test. Actually, if we pull up the exam here, some of these questions
can be quite tricky. Question number nine: Blacks, on average, have denser,
stronger bones than whites. Most laypeople and even some
doctors may have trouble. It’s true. That is a biological
difference between the races. It changes the rates of certain conditions that can affect our bones
moving forward later in life. The question listed as
number eight in the study says black people’s skin has
more collagen, in parentheses, i.e. it’s thicker, than
white people’s skin. So it didn’t just say thicker, it talked about a specific
makeup of the skin, of collagen. It’s not crazy to believe that there’s differences between collagen. It’s just a mistake or
a lapse in knowledge. I don’t like that he’s
trying to draw a parallel as if it’s a racist person
making this assumption. – That is not the only insane
belief that that study found. 14% of second-year med students agreed that black people’s nerve endings are less sensitive than whites
which they obviously aren’t, and 17% believe that black people’s blood coagulates more quickly than whites, which it obviously doesn’t! – I don’t know how he says
it obvious that there aren’t. There are biological differences, and second-year medical students, 10% of them are allowed to
make a mistake on an exam. To point us out and say it’s
obvious that they aren’t, I would like to see John Oliver,
especially as a layperson, hear the point that blacks have more dense bones than whites, I’m curious to see it’s
obvious that’s not true. He’ll be making a mistake. – Black people, we don’t even
get our hands on opioids! (audience laughing) They don’t even give ’em to us. White people get opioids
like they Tic Tacs. – First of all, I love Wanda Sykes. I think she’s absolutely hilarious. What she’s saying is true. The opioid epidemic has
disproportionately affected the white community way more
than it has the black community which is a result of the overprescription of opioids to the white community. – One recent analysis
found that black patients were 34% less likely to be
prescribed opioids for pain than white patients
with similar conditions. And while there are a lot of good reasons to prescribe fewer opioids, my patients are black
is just not one of them! – We have to figure
out how that bias forms and where these patients are
more likely to be treated. As I mentioned earlier
in some of the segments, that unfortunately, the African community attends lower quality hospitals. In lower quality hospitals, doctors are generally
faced with more patients, less resources, and
they’re facing patients that may be facing homelessness, they may have substance abuse issues at a higher rate than the white community, so they may be more reluctant to prescribe opioid medications. I think we need to do a better job at formulating our research to not only find out
that, A, this happens, but to try and figure
out where this happens. Is it happening in isolated centers? And then we can focus on these centers and figure out what’s going on, why these biases are occurring or these disparities are occurring. – If you consistently have bad
experiences with healthcare, you might be less inclined to seek help that you need in the future. – This is important to
note in both directions, that if you consistently have
bad experiences with doctors, you’re less likely to trust them and less likely to seek help. John Oliver’s absolutely right. That’s the human condition. Now, I also wanna bring forward a topic that’s not as much discussed in that doctors, throughout their day, are constantly seeing
drug-seeking patients, are seeing patients who are
selling their medications, are seeing patients who are not compliant and the doctors may be genuinely worried about the abuse of these medications. That can not only trigger doctors to prescribe less of those medications but also have a genuine concern
as to if they prescribe it, are they doing a disservice. I’m not excusing the fact that doctors are
prescribing 34% less opiates to black patients than
they are to white patients. I’m just merely saying that we should really take a look at this and figure out why this disparity occurs. I’d like to speak up for
the medical community because I know doctors, in some of these low
socioeconomic communities, are dealing with less resources,
less time per patient, dealing with very difficult patients, and patients that maybe
have incomplete insurance or poor health coverage and the only thing they can prescribe and that the patients
can afford is ibuprofen and that’s horrible to say! In talking about all this, it may seem that I’m ignoring the bias or discrimination that can occur. This absolutely occurs. And I’ve heard anecdotally
from some of my patients where this has happened and it sickens me and we need to talk about
that, put that in the open, but now put an over focus on that where we miss systemic flaws
like socioeconomic factors, quality of hospitals, the quality of insurance
that patients have, because unless we address all of these things simultaneously, we’re gonna make progress in
one area but fail in another. I wanna help patients as much as I can and not get short-sighted and focus on only the
most inflammatory factor. – It was just this belief
that I was making things up, that what I was saying wasn’t real, that I must be seeking
drugs or selling the drugs or some such thing. – That’s what you were getting
in the doctor’s office? – Oh yeah, absolutely! – See, this is horrible. But what I will say is now
we’re establishing guidelines that will allow us to avoid
these awkward interactions. For example, we’re creating pain contracts where if we’re establishing with a patient that we’re gonna be giving
them controlled substances, we create a contract. This is how it’s gonna work. We’re gonna give you X number of pills. If you lose your pills,
this is the plan of action. If you are traveling, you have to take your
medications with you. And there’s all these
guidelines that are set so that the patient knows what to expect, the doctor knows what to expect, and there’s no surprises and
no feelings of discrimination. – And there’s perhaps no stocky expression of where sex and race can negatively impact healthcare outcomes than maternal mortality. Currently, The United
States has the highest rate of maternal mortality
in the developed world. – This statistic receives
a lot of publicity and there’s a few interesting
theories that people have. First of all, the maternal
age in The United States who are having babies later in life, we’re the most obese we’ve ever been, which obviously lends to
a lot of complications when it comes to pregnancy
and post-pregnancy, but then I found a really
interesting article that suggested this theory. Scientific American showed the statistic that the maternal mortality
rate from 1999 to 2002 was about 9.8 per 100,000 live births. And then if we fast forward 10
years later to 2010 to 2013, it jumped to 20.8 per 100,000 live births. What they say here is really
the most interesting part. The numbers in the latter
period may have been affected by a small change in the forms that are filled out when a person dies. Until relatively recently, most states relied on a
death certificate form that was created in 1989. A newer version of the
form released in 2003 added a dedicated question asking whether the person who died was currently or recently pregnant, effectively creating a flag for capturing maternal mortality. The addition of this question means that the apparent increase in
maternal mortality in The US is quote, “‘Almost certainly
not a real increase. “‘It’s better detection
from new certificates.’ “says Robert Anderson, “chief of the Mortality Statistics Branch “of the CDC’s National Center
for Health Statistics.” The CDC is saying we’re
not actually seeing more maternal mortality in our country. What we’re actually seeing is better representation
of that mortality. – If you’re a woman of
color in this country, especially if you’re black, your odds of dying in childbirth are three to four times higher
on average in our country. – Why? ‘Cause you’re not talking
about access to healthcare. You’re not talking about
money or education. – No, and this is gonna be hard to hear. We believe black women less when they express concerns about the symptoms they’re having, particularly around pain. – These racial disparities
exist even when you control for socioeconomic factors like education or insurance status. We are literally disbelieving
black women to death and that is appalling and often– – That is appalling! There’s no doubt that this happens and it needs to be addressed
on a systemic level. I don’t wanna get caught up and believe that’s the
only thing that’s happening because researchers have found
other contributing factors like the researchers in New York who found that up to
half of this disparity can be as a result of black patients attending lower quality hospitals, but then even then, we need to figure out why those lower quality hospitals are contributing to this
increase in maternal mortality. Is it genetic? Is it because they’re
predisposed to illness? Is it because there’s lack
of preventive care options? And until we have this
difficult discussion, we’re never gonna figure
out how to close that gap. I wanna come in from the
optimistic side again and let you know that there’s
actually millions of dollars that are being dedicated to looking at all of these gender issues, race issues, maternal
mortality issues from Congress to figure out what’s happening,
to conduct proper research, to improve our screening methods. And again, I wanna hammer this point home that a lot of these studies
were done 10, 20 years ago and that already we’re seeing improvements in the way that we treat female patients, in the way that we identify our bias, in the way that we understand that we need more diversity in medicine, that we’re trying to create
funnels from different cultures to come into the field of medicine through scholarship
programs and all of that. In fact, I work with the STFM, the Society of Teachers
of Family Medicine, who have scholarship for minorities that I’ve actually donated
to and partnered with through my foundation Limitless Tomorrow. And the more we can do that, the more we can get onboard
with this type of diversity and bias training and acknowledgement that our system is failing
certain minority groups, we can all do better. We’ll all improve as a result. This is obviously quite
a controversial topic. Uncomfortable for me to watch, uncomfortable for my colleagues to watch, but I think it stimulated some really good conversation among us. If you have any outstanding
comments or questions or even experiences
that you care to share, drop ’em down below in the comments. I’m all about stimulating
happy and healthy conversation, especially if it means we’re gonna improve the healthcare field. And definitely click on this video. And as always, stay happy and healthy. (smooth hiphop music)

100 comments

  1. Thank you for you analysis Doctor Mike. It's so rare to see a logical argument against people taking things out of context for their bias.

  2. i love this video! Can we please recognize all of the errors in healthcare that make us feel deterred from even going to the hospital for help.

  3. Dr. Mike unfortunately this is a good chunk of doctors out there that treat us like this. You always say "have a conversation with your doctor" and I tried to talk to mine who literally gave me a 2 min window to speak before he was packing up his computer. Do I as a woman need to bring a fact sheet with bullet point symptoms to avoid "narrating" to get proper treatment? Because some of us don't have time for the medical community to catch up.

  4. I'm still traumatized by the male doctor I saw in the E.R. when I was 19 years old. 8 years ago. I haven't seen a male doctor until recently when after seeing two different male doctors and "having a cold" for two months that finally went away on it's own. Kept having me buy stuff off the shelf which don't you know isn't covered by my insurance. I'm not saying behind the counter drugs were a good first option but after two months and two doctors and all they are "prescribing" is nyquil and a good night's sleep but I'm still just as congested and gross as the day before…I don't think it is a cold anymore. I will never know what I had or if it even has fully gone away or just laying dormant. I have had full health insurance for the past 4 years (thank god) and still haven't found a primary care that can take me. Most women doctors in my area never have openings and the ones that do are usually poorly rated or I haven't liked them. Of course every male doctor in my area is always taking new patients but do I really want to chance not getting the healthcare I need.

  5. Its really frustrating as a medical intern to watch some comedian slander our profession as blatantly sexist or racist. I see doctors everyday slaving away in rough conditions with meagre resources trying to help people, regardless of sex or race and this is the PR they get from these clowns. Smh.

  6. Mike, the opioid crisis in America started in very low socioeconomic areas in the Appalachians. Your assumption that white people are getting more opioids because they are wealthier is inaccurate.

  7. I was having gallbladder attacks while I was pregnant the er Dr literally had to explain why I needed the pain medicine because I was rejecting it

  8. Why downplay the significance of racial bias & the possibility that some healthcare professionals do not put as much focus into treating black patients, while also amplifying the truthfully minute biological differences across races & highlighting the economic disparities as if all black people are poor & that's the reason for their poor treatment? You were more understanding of the gender biases but spent a lot of time poking holes on the racial side. It's a fatal flaw to minimize or discredit the impact of racism in society when it isn't an issue for you. It is real & it permeates many aspects of society & only gets stronger when public figures are uncomfortable being honest about it. It might've helped if you interviewed a black medical professional who understands the realities a bit more.

  9. I’m a quadriplegic woman, paralyzed in an accident when I was 34. I have a graduate degree and had a successful career before my accident. I am articulate and extremely well educated on all of the body issues my paralysis causes. Doctors literally treat me like garbage There is a terrible disability bias. Medical offices are shockingly non-accessible to people confined to wheelchairs. Moreover, doctors also assume that if you are in a wheelchair, you are likely some hot mess of medical problems and/or are addicted to opioids. I once tipped backwards in my manual chair, slamming my head into the pavement so hard that it fractured my skull. I waited 16 hours in the ER without being seen by a neurologist despite a CT showing a 3 inch long fracture. No one offered me so much as a Tylenol . . . for 16 hours! They parked me in a room and ignored me. Sadly, that’s a pretty typical ER experience for paralyzed patients.

  10. i'm 7 minutes in and i'm extremely frustrated by the way you deflect or play down the whole bias issue by saying " we don't know the cause" "there are many OTHER factors" because it shows you're not listening!!! women and poc are telling you their stories!!! please for once don't get defensive and listen!! we all want the same thing. also no offense but you're WHITE. MALE. DOCTOR. the last person we'd ask if bias in medicine exists.

  11. Alright Dr Mike. I’m female…..I am not atypical. I’m just not a man. You are being very defensive rather than hearing what is being said. I can tell you that I have had way more bad experiences than good as a woman that has gone through cancer treatment and long term chronic pain since then. And women who go in and complain loudly are ‘hysterical’ but if you are calm and precise then ‘it’s obviously not that big a problem if you can sit here and talk about it so calmly’. What am I supposed to do about that?

  12. And the “bring a white guy” bit was hilarious, because like most things- its funnier because its TRUE. For 8 of the last 10 years, fighting for a diagnosis as I’ve become more and more disabled (i’m only 35), my husband has gone with me to every new doctor and the difference is dramatic in how I’m treated.

    If he puts on a tie and does most the talking about MY symptoms and its gobsmacking how urgent and serious my issues suddenly are to these doctors.

    Unfortunately, when I finally landed at Hopkins with a world-renowned cardiologist, who did diagnose me with a rare condition, my experience was just as bad personally. The doctor was arrogant, flippant, and couldn’t be bothered to look up from his clipboard or even speak to me without a dismissive tone. He was also rude to his nurses in front of me. My husband finally stood up, a good 6 inches taller than the doctor, and that snapped the doctor out of his little bubble.

  13. He talks a lot in the video about how we should discuss ways things are improving but completely skips over the end of the John Oliver video where he talks about possible solutions

  14. Dr. Mike. I'm sorry but this earned a side-eye from me. Racism exists. Black women die during childbirth more than white women and how many studies have to be done that shows it has to do with the fact that people don't believe black women? Doctors used to believe black women didn't feel pain and would experiment on them! Black Women don't get the same quality of treatment! Period

  15. I think you completely miss the point with the racial bias that there aren’t biological differences between races because race is a social rather than biological construct

  16. i was sent to therapy when i was 8 because my (male) pediatrician convinced my mom and me that my stomach issues were all psychological. i went to so many different doctors and specialists who told me i was healthy and i just needed to gain weight. i was 13 when i was finally diagnosed with celiac disease after a simple blood test, followed by an endoscopy. nobody bothered checking my blood for things besides food allergies or vitamin D deficiencies. it’s scarring when you KNOW something is wrong but you are told again and again that you are perfectly fine. when you have to accept pain and discomfort as a new normal. the same thing happened again when i was 15 and i had horrible periods and pelvic pain. i was blindly diagnosed with endometriosis. i bounced around 3 different gynecologists offices that year. they put me on birth control, which i reacted badly to. i stopped taking it after a year when it became unbearable. when i was 18, my pelvic pain got worse and my stomach blew up like a balloon. went to a new doctor, even though i knew i was going to get pushed aside. she was thorough and after blood tests, an ultrasound, and an external exam, she told me I had PCOS. these things aren’t that hard to notice or diagnose, yet it took me multiple doctors and many years of suffering to get answers…

  17. Ok. Um… I don’t have a better way of saying this but…here goes. There are a few assumptions being made around the term “African American community.” So, I was always taught the “African American community” refers to African Americans as a whole population of people in the U.S. and not just neighborhoods that are predominantly African American. Also, not all predominantly African American communities are socioeconomically disadvantaged or socioeconomically consistent. That doctor never mentioned the socioeconomic backgrounds of the excess 83,000 African-Americans he was speaking of from the study mentioned. Let’s not assume that “African-American community” is consistent with socioeconomic disparities. Furthermore, let’s not assume that because you’re African American you live in a predominantly African American neighborhood. John said African Americans typically receive less care but he didn’t specify where they lived.

  18. As a young girl like 12-14 every single time I went to the doctor they acted like I was over reacting about everything, I was given a pregnancy test and when I would say I was a virgin they just looked at me like “yea that’s bull crap”. Yes I understand they still have to test me Bc if I was pregnant they would have to treat me different or look into other types of problems. But the disrespect and shaming I got for no reason was ridiculous. I would say I don’t do drugs and they look at me like I was lying automatically.

  19. Reading a lot of these comments I don't think you all are really getting this video. It's not in opposition to John Oliver's Piece, if anything this is a companion piece. Mike never said that Bias doesn't exist, he just didn't focus on that aspect since John did a fantastic job at explaining that aspect, he was just bringing to light other issues at play here that are just is important (not more important) Just as important to resolve as Medical bias for a stronger Medical community as a whole.

  20. Its so uncomfortable how often he deflects or does "whataboutism" to not talk about the central issue Oliver is focusing on.

  21. It seems to me that you keep making excuses for the biases of the medical field and keep ignoring what thousands of women and poc have said about the bad treatment they received. Being an old doctor is no excuse for not keeping up with the advances in medecine, especially when there are journals, online articles and conventions catering specifically to doctors with that purpose in mind. Saying that "well women describe their symptoms differently" is no excuse for not taking them seriously. You are a doctor, you should be trained to talk to every kind of patients. If someone who suffers from anxiety comes to your office for an unrelated medical issue, you don't dismiss them because "they are probably overreacting" or because they have trouble finding words to tell you what's wrong. And the whole thing about "women have a responsibility for not getting treatment in time because they prefer to take care of the kids"? Do you realise that we live in a fucking sexist society that asks of them to be a worker, a mother, a wife and a housemaid all at the same time? And that this same society won't easily allow men to take long enough paternity leave or just be at-home dads? And what about single moms? Saying women are to blame for not having enough time to take care of themselves is just plain wrong and disgusting. And it's just a way for hospitals and healthcare systems to avoid taking responsibility.
    And if you still don't know why poc receive worse treatment and why they attend less funded hospital, it's because of their socio-economic status, because of gentrification and overall because of systemic racism.
    The fact that "your" hospital or "your" team is making progress and is trying to adress bias is good but it doesn't mean it happens everywhere else. Maybe there's no problem at your local scale, but it does not mean you should be content with that. It doesn't mean that you, personaly, have to take care of the whole issue, but in this video you're nitpicking at the studies, dismissing patients' testimony as anecdotal, you're eluding the points made in the LWT show and you're actually distracting people from the systemic issues of racism and sexism that are present in your field, preventing the implementation of any kind of real global solution to adress those.

  22. You make Oliver's point when you call women's heart attack symptoms "atypical" to mean that they are different than men's.

  23. I’m a black 2nd year medical officer intern in South Africa 🇿🇦 and all I got from this video is that black communities have poor quality hospitals and that’s why they’re neglected. Basically what you’re saying is that it’s not about racism. Your reasoning is terrible, especially considering the mere fact that black communities have poor health institutions and whites have the state-of-the-art hospitals is in itself institutional or systemic racism no different from Apartheid South Africa 🇿🇦. Quite frankly I think John Oliver addressed the issue way better than you have. Stop defending the system doc. And I don’t even wanna go to the collagen story #disappointed

  24. l respect this doctor and this video so so so much. I actually got emotional hearing a professional acknowledge these differences in healthcare, but then also speak to the future and the hopeful outcome of these studies.

    If every doctor is taking these concerns as seriously and as well researched as Doctor Mike, I feel very comforted in the future of gp medicine.

    thanks for this video, I learnt a lot.

  25. I've definitely felt not listened to from my doctor, but I have no clue what kind of bias it was. When I was first getting on birth control my gyno did not listen to my concerns at all. I was mainly getting it for hormonal regulation/acne control, but I felt like my doctor only saw it as a way for me to have sex. When the first one gave me HORRIBLE side effects, he told me to stick through it, even after several months with no improvements. I stayed with him for about two years but he would only see me for about 1 minute every visit and would not listen to what I was saying in any way. The whole time I was with him neither of the two original causes were addressed. Thankfully, I was able to switch doctors and now have one that actually listens to me and a BC that I have been on for years that works great with my body. I have heard stories from others, where they didn't have the option to switch because there was nobody else in their area. I couldn't imagine still being with my first doctor.

  26. Hello Dr.Mike I have a question for you…if I brake my bones in thousands of pieces I need to amputate or there is another way?

  27. If you step back from clown world for a moment, John Oliver is complaining about white males in medicine not doing enough to help everyone else. White males invented medicine you ungrateful swines.

  28. I think it’s true that in many understaffed hospitals doctors are doing there absolute best to treat as many people as possible with limited resources and when they cannot spend more time on them or prescribe more expensive medicine it has nothing to do with racism at all. But then the overlying issue of black people having worse access to healthcare or a lower income is an issue of racism again, because they are disadvantaged by the system and still treated with bias.
    Another point, and I know many people don’t like to hear it, is that we need a general public health care system. Of course that’s difficult for a country this big but if others can do it, we can, too! The big advantage is that once you are entitled to a specific treatment or medication and payment is guaranteed, no matter your income or position, there will be a lot less differences in how people are treated. I think that’s worth the effort!
    In the mean time keep up the good work Mike!

  29. I'm white and just recently saw a black doctor who was very disrespectful and even mocked me during my visit. Am I allowed to be critical of this?

  30. Wasn't it one of John's points that it's a bias in studies, knowledge and interpretation, not individual practitioners. My thought is that with the century or so of biased studies, could take a very long time to resolve. As I expect funding is easier to gain for new research rather than redoing an old one incase some form of bias wasn't analysed.

  31. OMG. I have that same shirt! It’s thick material and super hot in the summer. But a nice shirt none the less… ok. Anyway…

  32. The issue he mentioned about medicines not working in women the same as men and having other complications is not just because historically men's bodies are what were studied. Research involving animal models in medicine has been almost exclusively male animals. This has been done because the male body doesn't exhibit the hormonal variation that the female bodies does along with some other factors but what it boils down to is researchers only considered how having a more consistent male model worked for them and not what these differences mean for applying these medicines/treatment in the entire human population. It is only recently that pharmacological research has started including female animal models and it is still not a requirement last I saw.

  33. Super conflicted about this video. I like you and John Oliver but I don’t think I feel comfortable with 2 cis white men talking about this.

  34. So I think you may have missed the point that this is not really about blaming doctors, but the legacy of institutionalised racism and gender inequality that has been around for decades – the fact that we have decades (more than decades) of research and teaching not just in medical schools but in the wider society about the body that has been based on a 40 year old white male. I used to be a Health Scientist (I specialised in looking at women's health and did my thesis on provision of culturally appropriate maternity care for my undergrad) and that stat about USA having the worst maternal mortality rates was true in 2002 – before the new way of recording you've mentioned in your video. There were studies and research that believed this would be because of the over medicalisation of childbirth in the USA (you tend to have much more medical interventions from women being seen by OB/GYN even with low risk pregnancy, and I think I'm right in saying you have insurance companies and hospitals which don't allow certain birth choices like having a midwife. Also the fact that not all 'midwives' are actually trained, qualified and registered midwives like they would be in UK, Netherlands etc.) Similarly on the issue of race, I think you only have to look at the criminal justice system and the bias in how someone of colour is treated vs a white person when it comes to drugs. I don't think that it takes a scientist to see that if educated judges are treating people of colour found with illegal drugs differently (how many white people of high socioeconomic status go to an expensive rehab facility instead of prison?) and it's not a wild leap to see it's likely that the same thing happens with hospital staff. It's not unique to the medical community. People of colour not getting the same pain management is a product of systemic racism in our society as a whole. The same way that women haven't been taught that the symptoms of a heart attack are unlikely to be tingling left arm and chest pain. I'll also say that as a woman, I've received all sorts of bias from doctors. Every time I go I get asked if I'm pregnant (with one male doctor in A&E apparently thinking that I was also deaf when he turned to a nurse and told them to do a pregnancy test as I was clearly lying as he walked away). Even a female women's health practitioner told me she thought pain I was having was in my head – despite the fact that no nurse has been able to do a cervical smear because the pain has been so severe that I just about went through the wall of the nurse's office. I have had girls and women spend years being in such horrific pain during their period and ovulation they've been mooing, screaming, vomiting or fainting – and yet no tests for endometriosis is done. Teenage girls in particular tend to just be put on the pill, with no discussion or information about what type of pill they are being put on, side effects etc. The idea being to treat symptoms not find a cause. It's also astounding that so many OB/GYNs have such differing knowledge on things like PCOS, endometriosis, fibroids… never mind family doctors who would be the first port of call. Trust me, if a woman is coming to you about severe period pain, it's been going on for months or years before she's come to see you – because it's taken a while to realise and discover that what she's experiencing isn't 'normal'.

  35. I feel like half of what Mike is saying here is "But how much of this systemic discrimination is specifically and irrefutable coming from us?" which honestly isn't very encouraging. Heart is in the right place, but gotta get past the defensiveness.

  36. It’d be better if Dr. mike has just sit this one out! So disappointed with his pseudo optimism. I feel like he has been sent!

  37. I've experienced things like this as a patient. On different occasions, from different doctors of varying ages, race and gender. I typically go to hospitals that are considered the main ones in my city, so they are not underfunded. As recently as 2017. I have lost a lot of trust now. I have a hard time convincing myself to go to the doctor. It's just that there is no other option.

  38. What is "narrativizing" symptoms?

    What is this "Women have to pick up the kids and take the casserole out of the oven" excuse? That's really dumb.

    You know what stopped me from going to the doctor when I had pneumonia? "They'll just tell me to take benedryl. My asthma is just worse than usual." Because that's what used to happen (also I should have been on a steroidal inhaler but wasn't) I'm very lucky my dad's doctor thought to ask if any family members had similar symptoms. I was too weak to go to the doctor by myself at that point.

  39. If there were a way for you to discuss socialized medicine from a provider's standpoint, that would be very interesting! I know it is a very sensitive topic and will be difficult for you, as your viewers are quite diverse, but I would be keen to hear it! You have a way of addressing issues in an objective, respectful manner.

  40. I hate the part where John highlighted that even when you control for socioeconomic factors there is a still a disparity and Mike just went back to lower quality hospitals. Also Latinos often use those same hospitals as well and they don’t have the disparity. Mike kept saying that he was not trying to play down the bias but it seems that throughout the entire video that was all he was doing.

  41. lol thanks for making this so i can watch this episode of john oliver. Almost all of his videos are banned in Canada. No idea why

  42. This is America in 2019. For all that American proclaims to be, the fact that you can say “lower quality hospital” is an absolute intolerable disgrace.

  43. There are not racial biological differences. There are regional difference. See. Dr. Dorothy Roberts

    You are proving John Oliver’s point with your denial of bias.

    Doctors give white people more drugs because they don’t care about black people.

    Your bias is showing.

  44. Okay I see where Dr. Mike is coming from but at the same time does he see where we're coming from? My sister is a middle class white woman but her husbands in the military so they have really good health insurance; who for years suffered horrible pains during her period, fluid retention in her legs and incredible weight gain. Even though she was eating healthy and going to the gym almost 24/7. She went to multiple doctors (most of them male) and all they would say to her would be "Maybe you wouldn't feel so bad if you weren't fat" Actual quote from an actual doctor that she saw. She would explain to them over and over again that she was healthy but couldn't lose weight and that her period felt like she was being murdered. But none of them believed her or thought she was overreacting.

    Then she finally found a good doctor who ran some test and guess what, she was having a bad reaction to the birth control she was on and they found out she has PCOS. So then that doctor took her off of that birth control but then told her that her PCOS was bad but not bad enough to actually give her any meditations or offer her any surgeries to help with the condition. So it was like oh yea that's bad but it's not bad enough.

  45. Hi Dr mike
    I'm a female teenager a keep getting headaches which make me vomit and make me feel light headed what would you recommend me doing.
    Btw I wish to be a doctor

  46. Sorry Dr. Mike, this is the first video I’ve watched of yours where I just have to say- you missed the point.

    I feel like I just watch 30 minutes of you grasping at straws to defend the medical community, and downplaying the very real and very dangerous biases that exist for women and people of color by saying repeatedly “we don’t know WHY these disparities exist” and callIng the experience had by many, MANY thousands of women merely “anecdotal”.

    Take a little dive into the chronic or rare illness communities on social media. You won’t find ONE SINGLE female patient who hasn’t been dismissed multiple times by being told its an “emotional” issue when simple tests came back showing nothing (as they often do in rare diseases). You won’t find a single one hasn’t been treated like she is “hysterical” or attention-seeking. And you WILL fine unending comments from people who have, and are still, suffering these frankly traumatizing indignities ALL THE TIME.

    And since its not rare to have a rare disease, doctors need to stop with the old zebra and hoofbeats addage.

    A rare disease is one that has less than 200,000 sufferers in the US. Yet over 300,000 patients have a rare disease- and that’s not counting those who haven’t been diagnosed! That is almost 10% of the US population! Patients with rare diseases won’t be rare in your practice, and if you think they are you are likely missing something as a doctor.

    Sorry but I think that your life experience- as a young, healthy, attractive (yes, looks matter tremendously in how women get treated by their doctors as well), male doctor who is fairly enlightened really made you biased in examining this subject since you just can’t relate to what its like to be practically begging for help and written off as attention seeking because you are a white man.

    The fact is this: we think white men are serious and tough, and if they are complaining (about their symptoms- or behalf of their wife/children even) it MUST BE SERIOUS.

    And we think women are fragile and weak and prone to “hysteria” and just want attention (from anyone apparently, even if its extremely expensive and impersonal as in the case of a doctor 🙄). I will never understand the arrogance a doctor must have to think so much of his own company.

    The fact is women typically handle pain better than men. We are no more prone to mental health issues than men. There is ZERO evidence that women go to the doctor just seeking attention in any remotely significant number AT ALL, or in comparison to men. That is a narrative started and perpetuated by doctors ALONE for decades when they couldn’t find an easy reason for the reported symptoms of women.

    The only thing I will agree with you on is yes, there is a need to understand WHY the biases exist and WHERE they originate so we can begin eliminating them. But frankly that’s an academic discussion.

    The WHY and WHERE questions are not questioning that there IS serious bias, just the cause. And when you are the patient experiencing that, those questions don’t matter because even if you had the answer in that moment it wouldn’t help you.

    The bias IS there, and its often very, very ugly and the last thing a suffering patient expects or needs when they go to a doctor. The bias, unfortunately, is MY problem as a patient. WHY its happening is yours as member of the provider class and frankly not relevant here.

    Also, I watched the whole John Oliver piece and feel like you cherry picked things you thought you could half-way defend, leaving out others which are inexcusable.

    I have no doubt you care for your patients and are careful to not subject them to these things, but your affinity for your profession, and being raised witnessing your father’s care for his patients, I think has blinded you to how FAR, FAR TO MANY of your colleagues behave behind closed doors. But there are thousands of voices right here that will tell you, if you can stomach listening.

    Also, a pretty simple test for doctors to run on themselves when dealing with how to treat subjective symptoms like pain, or symptoms they can’t explain easily is to ask yourself this: “Would this be my conclusion/ diagnosis and treatment plan if it were a white gut in a suit telling me the same thing”. But that takes a level of self-awareness a LOT of doctors lack. MOST doctors can’t handle being questioned in any way and certainly aren’t inclined to criticize themself or how they have been practicing medicine their whole life- most are simply too arrogant.

  47. This may be kinda off topic but kinda on but I have GAD and emetophobia so all of my digestive problems get attributed to that and I feel like none of my doctors have expressed doing any kind of digestive or nutritional testing. I’ve been feeling crappy for months/years and each doctor just says it’s my GAD. I’m sure there’s a connection but it does feel like I’m just not being heard

  48. To the people getting mad about his stance(s): Did y'all even listen to him? He consistently does put blame on the medical system and understands the presence of bias and systemic issues. He identifies them consistently. Also he did not fault the women, it's simply a biological, factual trend that women present in more "hidden" ways (heart attack-wise) therefore making a male diagnosis easier for a physician, and he does highlight the fact that we need to be educating physicians in this way so as to combat the systemic issues of the past. And he brings light to the positive side of this research (gaps are closing) to show the ways we can take steps to combat these legitimate issues. He is so clearly aware of bias and systemic racism/sexism, he's just doing the right thing by looking at data holistically, trying to understand how it was produced not only to give a better picture but to better serve patients as a healthcare system. I realize I am a majority and it's much more rare that I'd have a bad experience but that's the whole goal here that he's pursuing – to be aware of that and do something about it.

  49. If the mortality rates have been that high the whole time but weren't always reported or counted, then this explains why for years I've heard it said that black women and babies are killed on the birthing table. It's certainly not new.

    And this treatment doesn't just happen at hospitals with less money. It happens in well funded hospitals as well.

  50. I thought this was halo content saying medicant bias and not medical bias.

    Single payer for the working class let the rich pay for it through small stock tax. Single payer now. Bernie 2020.

  51. I had great experiences with most doctors until I switched from pediatrics to adult care. I'm an African American female with sickle cell Anemia and I had a pain crisis and went to the ER in a very nice area. It took me hours to get an IV, I didn't see my doctor for multiple hours who discharged me without talking to me first, and sent me home on a low dosage of pain medication I had when I came. I had to come back in a day. It ended up being my longest hospitalization because the earliest hours/days are the most important. My second doctor in the ER was much better. He asked me what I needed because he knew I knew my illness better than him. It's unfortunate but he understood that the majority of the patients he treats are white and do not have my disease. My frustration lies with the other two doctors I had in that experience who seemingly didn't look at my charts or history or even talk to me.

  52. Well, since we’re all giving opinions, and this video was to start a conversation. I wanna say, I enjoyed the video, a lot actually. I appreciate the fact that Dr. Mike brought up that there MIGHT be other reasons other than racism/discrimination. My brother in law, a WHITE MALE, has had TERRIBLE luck with doctors, they have misdiagnosed him more times than I’ve been to a doctor, he’s gotten wrong medication more times than Dr. Mikes uploaded this year, and I truly believe it has to do with the areas he chooses his doctors.
    For everyone complaining that he ignored the fact about doctors being racist, I want to point out that he didn’t. He said that there definitely is a discrimination occurring, but we can’t always blame that when sometimes that’s not the case.
    Dr. Mike is doing the best he can, in this case it’s make a video to start conversation, to hopefully catch the attention and then begin further researches, he can’t go to EVERY SINGLE hospital in America and educate all the doctors. He also wasn’t going to sit there and agree 100% with everything John Oliver said, it’s his colleagues after all, it’s his profession they’re trying to seem is evil, he’s passionate about medicine and he’s trying to find other factors, but that doesn’t mean that he doesn’t believe they aren’t racist.
    I just think y’all need to pay more attention to the video, once we fix the other issues Dr. Mike believes are causes of bad treatments, then we can find the ones that are being racist…

  53. Quick comment… I saw the video on my list, and thought "Cool! Here's going to tell us about the errors in Oliver's show"… But thing after thing was just saying Oliver's thing did a good job… You could have saved people half an hour by just sharing people's queries by saying that…

  54. I understand that as a member of the medical community is can be hard to hear, but let me level with you: it’s racism and sexism. Blaming obesity, class, and patients not properly reporting their symptoms doesn’t change anything. Perhaps, when women and poc (and ESPECIALLY women who ARE POC) tell you that doctors treat them poorly, listen.

  55. The opioid example was a racial disparity. Wanda Sykes’ example was the “joke” about her having a double mastectomy and getting ibuprofen. I was a pharmaceutical rep and (for whatever reason) a doctor told me he didn’t prescribe prescription medication to the African Americans because he thought they are on Medicaid and he’s paying for the prescription. No clue why he told me that.

  56. So in other words, us women need to pray we dont get an older doctor? I'm so glad I can ask for the lady doctor when i go to the GP

  57. I really respect you for the way you speak on these claims and how these studies are interpreted. The media, even John Oliver, have a tendency to jump to conclusions after reading the title, and not actual presenting the full outcome. I myself work in a pathology lab setting and I am but one of a few men amongst a host of woman, so I was sceptical when hearing him speak on the bias against woman in medical care, because then its woman, who treat woman this way as well. I really think he did a disservice in not also mentioning the ratio of woman to male care providers.

  58. In a "100 years" I would hope an AI diagnoses and treats you not a human. However, for now perhaps the best choice is to find a doctor that's the same race and gender as yourself.

  59. I love liberal media, an issue that used to be something dire but is getting better gets infinite more attention and coverage because it has to do with women or african americans

  60. Thank you very much for commenting on this piece. I seriously respect the courage it takes to discuss such a difficult topic about your own profession and I hope that the medical community actually starts those conversations you mentioned about social inequality and bias so that the community can truly change for the better.

  61. In the last point he specifically mentioned how it didn’t have anything to do with economics, yet you still brought it up when you “argued” back. Seems like your making excuses Dr.Mike.

  62. Even when you control for socioeconomic factors, education, and going to the same highly rated hospitals, black women statistically fare worse and have worse health outcomes. This is not as a result of poor insurance, inability to afford medication, being non-compliant, or less access to quality healthcare. It is a result of bias. Until we acknowledge that, there can be no improvement. Stop blaming the victims and look at the systemic flaws.

  63. Last year I was in and out of the ER with chest pain and several real issues. I was in every day for the whole week. Apparently my xrays even showed pneumonia, but they didnt think it was worth mentioning. Had a young female PA come in and tell me I have just anxiety and I just need to calm down. By that 7th day I had developed severe tachycardia and was nearly non responsive. They finally transported me to the central city hospital, turns out it was healthcare related pneumonia from my work and it was trying to kill me. Thank God for the ID department taking over and saving me. And screw those drs who spent a whole week turning me away telling me I just needed to calm down and breathe.

  64. As time goes on it is not good enough. These older doctors need to be educated and like now. Very disappointed in the medical industry as a whole.

  65. I wish this doctor would research Thomas Jefferson and his writings where he said Black people dont feel physical and emotional pain to understand how deep this issue is. Also there are professional Black people who get the same biased treatment at the better hospital. This doctor's failure to consider that not ALL Black people have the same socio economic conditions is ignorance in and of itself.

  66. my old GP is an older middle eastern male who thinks all women are hypochondriacs. Went to see him because i had breathing problems (not severe enough to go to a&e) and he basically told me i was exaggerating. Changed my GP to a younger (also middle eastern) woman and was diagnosed with bronchitis. I am a white female who is 19. idk whether that other doctor didnt listen to be because of my sex or my age but either way it sucks

  67. My sister and her husband are both GPs, and I like to think they are good doctors who treat all patients the same, regardless of gender, colour or creed.

    Sure there might be a few inattentive or just downright arrogant and biased doctors, but at least here in australia, that shit gets shut down pretty quickly.

    As a standard rule, the people who get the worst treatment by medical professionals are drug addicts and alcoholics.
    Lots of drug addicts and alcoholics are troublesome (to say the least), but there are a few who don't act like assholes and treat doctors and nurses with respect.
    And we still get painted with the 'drug addicts are all shitty people' brush.

    I haven't touched any hard drugs in almost six years, but that annotation in my medical file is going to follow me forever.

    I understand the 'what's the point?' mentality and the aggravation that certain patients can cause (meth addicts and crackheads spring to mind), but its a pretty sad state of affairs.

  68. John Oliver didn’t mention this but there a huge systemic bias in healthcare against men: Sexual/reproductive healthcare. Men have no equivalent of an obstetrician/gynecologist. Men also need sexual and reproductive healthcare. Right now it seems like our system relies on men to bring it up, which how likely are they to do that if they are not experiencing a problem? I think primary care doctors should bring the topic up with their male patients, but based on both studies I’ve seen and anecdotal information, PCPs don’t usually bring it up.

    Women are usually asked about birth control and sexual practices by both their PCPs and ob/gyns. I think as a result they actually get better healthcare in this area.

    Given that some STDs are often asymptomatic in men, like gonorrhea and chlamydia, I think it would be better for both men and women, if men’s sexual and reproductive healthcare became standardized. The States have really high rates of STDs. Maybe making sexual healthcare for men standardized would help.

    As part of my annual physical and as a part of my annual visit to a gynecologist I get asked about my sexual behavior. I get questions about birth control, sexual practices, and number of partners. Various tests are recommended based on my answers. My husband and other men in my life are never asked these questions. I’ve only known of one guy who’s PCP asked him questions about his penis and sex.

    Of course it’s not just a matter of birth control and STIs. There’s also testicular cancer and prostate cancer. The only place I’ve ever seen information on testicular cancer or how to perform self exams is in Planned Parenthood clinics. I read about one study that found that men actually get the best sexual/reproductive healthcare at Planned Parenthood.

    This is an area of healthcare where bias is a serious problem. Maybe I can convince John Oliver to do a segment on it? Dr. Mike should do a video about it too. (If you have already, Dr. Mike, sorry. I haven’t actually watched all of your videos.)

  69. With respect to Dr. Mike, this all feels like a “Well, Actually” piece. He keeps saying that he is so upset by the bias in medical fields, but then jumps to say that “correlation doesn’t equal causation” and that it’s not what it seems. I agree we shouldn’t jump to conclusions, but when stats and evidence are so obvious, at some point you have to swallow the pill and deal with it.

  70. I started my period when I was 8, and started experiencing cramps around 10yrs old. I would have to go to the hospital every time my period started because the cramps were so bad. I've seen multiple docters about it and nothing gets done. So now I have to take 1,500 milligrams of neproxen just so I can feal my legs.

  71. You seem genuine but so naive. ~ makes me realise why it's so important to have women in roles of influence. Maybe it really does take walking in the shoes to be able to comment on what's the "causation"…

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