How health system ‘designed by men, for men’ is failing women

Two thirds of all females in Australia still feel bias and discrimination when accessing healthcare, according to the soon-to-be released End Gender Bias survey.
 
The full results, due to be released next week, will share the views of around 3000 women, including healthcare professionals, and are expected to include personal testimonies from patients who were told their pain was not real, as well as others labelled by doctors as ‘drama queens’ and ‘hysterical’.
 
The inequality is also not limited to patients, with separate research revealing around one third of all doctors in training have experienced sexual harassment in the workplace.
 
Ahead of the survey’s release, Health and Aged Care Assistant Minister Ged Kearney told ABC Radio women are still battling to access care in a health system ‘designed by men, for men’.
 
‘A lot of the care, clinical guidelines, a lot of the symptomology that you look for, a lot of those care plans that doctors rely on, even women doctors, are just about men,’ she said.
 
‘[Women] feel dismissed, they don’t feel heard, they get under-medicated, they get told, and I dare to use this word, that they could be hysterical, that they’re overdramatising.
 
‘Or even worse that, well, pain is just a woman’s lot – you just have to put up with it.’
 
Gender bias continues to be commonplace in healthcare across the world, and historically, medical research has often excluded women.
 
Last year, 40% of women still reported living with chronic pain, and one third said they have experienced ‘insensitive’ and ‘disrespectful’ practitioners.
 
Diagnosis of heart disease is a well-publicised example of gender differences in research, with women typically diagnosed up to a decade later than men.
 
Additionally, in the decade prior to 2014, American women suffered more than two million drug-related adverse events, compared to around one million for men, thanks to testing typically being carried out on males only.
 
Many women’s health conditions and reproductive decisions have also long been considered taboo, including menopause, endometriosis, and access to abortion.
 
The Chair of General Practice at Monash University, Professor Danielle Mazza, told newsGP women still often report feeling unheard or not taken seriously by their healthcare professional.
 
‘A lot of women are still facing major affordability issues, and a lot of products that women use, particularly contraceptive products and menopause products, are not PBS listed,’ she said.
 
‘In terms of maternity services, there’s a rapid discharge home after delivery because of the need for beds or workforce issues in hospitals, so women are facing major changes like breastfeeding or recovery from Caesarean section at home.
 
‘When women attend healthcare, it’s not a level playing field and women don’t feel empowered in those situations, so they’re looking for more information, they’re looking for choices, they’re looking for patient-centred care and shared decision making.’
 
Professor Mazza said it is more imperative than ever that both male and female doctors are trained in women’s health.
 
‘It’s becoming increasingly difficult to receive that training with fewer and fewer GPs rotating through obstetrics and gynaecology,’ she said.
 
‘And a lot of the gynaecology that GPs do out in the community doesn’t actually occur in the hospital setting, so it’s hard to get the experience that you need in hospital settings.
 
‘I want to make sure that our GPs of the future, and also our current GPs, have the opportunities to really receive high-quality training in women’s health so they can go on and deliver exemplary services.’
 
But it is not just patients feeling the pain.
 
The RACGP says female GPs are still getting a ‘raw deal’ when it comes to pay and entitlements, despite women now comprising more than half of all GPs in training (61% vs 39%).
 
College President Dr Nicole Higgins said GPs in training experience an initial drop in salary and loss of entitlements when they leave hospital settings to work in community general practice, and this is felt most acutely by women.
 
This falls in line with society more broadly, with women doing more work for less money.
 
New data has revealed across all employers, half have a gender pay gap of more than 9%, and just 9% of chief executives in the ASX300 are women.
 
Outside of the workplace, women also do more than nine hours a week more unpaid work and care than men.
 
‘We need to fix this disparity so Australia’s female GPs in training are not being paid less than other medical registrars,’ Dr Higgins said.
 
‘Australia is grappling with an epidemic of chronic disease and mental health issues, which require longer consultations for complex, ongoing care – this trend is not going away.
 
‘Women GPs should not be disadvantaged for spending the time they need with their patients.’
 
Those calls come at a time when 80% of female GPs report mental health in their top reasons for patient consults, compared to 60% of male GPs.
 
‘This is a pay equity problem because the Medicare subsidy for patients gets smaller the longer their GP spends with them, so women GPs who do more longer consultations are being unfairly penalised, as are their patients,’ Dr Higgins said.
 
As part of its pre-Budget submission 2024–25, the RACGP has already called on the Federal Government to roll out a 20% increase to all Medicare rebates for Level C and D consultations.
 
It is also advocating for paid parental and study leave to be funded for all doctors to alleviate these gaps.
 
Professor Mazza said looking to the future, with the increasing number of women in general practice, there is a need for this support and recognition.
 
‘We need adequate maternity leave, and sick leave, and carers leave in general practice just as hospital doctors receive,’ she said.
 
‘And if women are experiencing discrimination, they need to get support, to be able to call it out, and use their professional organisations to back them up and to support them to overcome these difficulties.’
 
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