Bias In Medicine: Last Week Tonight with John Oliver (HBO)

Bias In Medicine: Last Week Tonight with John Oliver (HBO)

John Oliver discusses the roles that gender and racial bias can play in medical treatment.

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65 Responses

  1. Con Bonison says:

    “The simple fact that you have to ask that question is a problem.”
    That’s god dammed right.

    • MegaDove says:

      It’s probably a good thing that AI computing is making its way into the medical field. Irony of computers…you can trust them to not be biased to particulars of human appearances…sure they might want to terminate us all…but it feels good knowing everyone will be fairly screwed.

    • Carter Wood says:

      *damned

    • kraay89 says:

      @MegaDove Actually that’ not true. The AI will be made by people who have these same biases. The AI will be trained using existing data which contains these biases. Racist algorithms are already a thing actually. There have been several studies already that support this hypothesis. For example in crime prediction (Guess what…). It’s just another can of worms waiting to pop if not dealt with appropriately.

  2. Leroset says:

    This is so true. I’m a woman. I’m very wealthy. I have great insurance. I went into an American urgent care clinic almost a year ago after getting back home from a trip with uncontrollable, unproductive coughing, mild lung wheezing, and an inability to sleep or work as a result. Heck, the coughing fits were so bad sometimes that I would get close to vomiting. I was also running a fever constantly.

    The male doc took a look at me, did a strep throat test, and it came back negative. He then got annoyed with me and said “look, I don’t know what this is. It could be viral or bacterial. Take this mild antiviral and antibiotic at once and take more Tylenol to keep your fever down. If you aren’t better in a week, seek further care.” He just wanted me out of the urgent care as soon as possible, since it was 2am.

    I followed his instructions to the letter and kept getting worse. I was losing weight and becoming delirious from lack of sleep. My lungs felt damaged somehow, and just breathing seemed to become difficult.

    I went to a different urgent care and the female doc there immediately took an x-ray of my chest. It turns out that I had bacterial pneumonia that was resistant to that weak antibiotic, and it had taken over much of my left lung.

    The female doc was shocked that it wasn’t diagnosed sooner by the other doc, and said that it would have shown up on a chest x-ray if he had done one when I saw him. And yes, the male doc had a working x-ray machine on site, along with the staff to operate it, during my 2am visit! He just didn’t bother because I guess he couldn’t take a woman’s complaints seriously, despite me being pretty much the most privileged demographic possible outside of being a male.

    Because my pneumonia had progressed so much, I had to take some pretty hardcore meds to get over it, and had to miss work for 1.5+ months, halt all exercise, and lost 15 lbs (which was dangerous for me, as I am already a svelte person). I also had to deal with extreme fatigue and inhalers for months afterwards. I’m lucky that I have the type of money and job to be able to take so long off of work with no issues, but it was an awful experience that escalated far beyond what it should have.

    Thanks, male urgent care doc, for not listening to me or for not bothering to do any of the logical testing a person with my symptoms should require! Had I been very young or very old, your lack of care could have killed me, since severe pneumonia kills tons of people every year!

    Also, I have to say, despite being very wealthy with great health insurance, a great job, lots of assets and savings, and many people to support me, this is just yet another example of how the American for-profit healthcare system sucks. I’ve used the universal healthcare systems in Germany, Finland, Hungary, Switzerland, and Japan, and they’ve all had healthcare workers that were more professional, less overworked, and happier, that cared more about my long-term and holistic health, without writing me off or being biased against me due to my gender or ethnicity.

    Also, in those countries I’ve never had to pay for co-pays, visits, testing, or meds beyond my tax contribution to the system. That amount is far smaller than what I pay for here in the US once you factor in my employer’s contribution to my insurance (which is money not going into my salary), my own contribution to my insurance, the co-pays, the deductibles (including separate in- and out-of-network deductibles), the non-covered tests/procedures, and the cost of medicine after insurance.

    Even though I’m comfortably within the top 1% in terms of income and wealth, it irks me to no end to know how much money I waste to get worse-quality care in the US compared to every other first-world country I’ve visited or lived in. I pay top dollar for my insurance, so I should get top service, but I am still treated better and faster, for less money, in countries with universal healthcare systems.

    So God help those of you that *don’t* have my wealth, insurances, and passports as a safety net in the USA. If your treatment is bungled or costs too much for you to afford in this country, praying for a miracle to save you is really the only recourse you do have. Unless you pass universal healthcare, but upon looking at the average brainwashed citizen, I wouldn’t hold my breath.

    • Nathan L says:

      @Demaryius Targaryen I was wondering that myself. If she has all this money, then why is she at an urgent care? Urgent care is where broke ass people, like myself, go and they are two steps above a prison doctor. Urgent care sucks, but when you have no choice you go to the doc that gives you Robitussin for a heart attack and sends your ass home.

    • noeldc says:

      TL;DR did she mention that she was wealthy?

    • romariohamid says:

      @noeldc was wondering the same thing πŸ€”

  3. loverlei79 says:

    White Female here. I am paralyzed completely on my right side and literally had a physical therapist come in my hospital room and demand I get out of bed on my right side.
    After 20 minutes of telling at him that I LITERALLY couldn’t move, he stormed out, marked my chart “Hysterical and Uncooperative”. I was denied physical therapy because of it and sent home.

    • Burf says:

      So getting refused care doesn’t just happen to black people? That’s kind of what this segment was conveying. I’m a white a male and have been brushed aside and not taken seriously plenty of times.

    • autohmae says:

      @Polio Nine This is why the countries with universal healthcare actually have less healthcare costs, people go to the doctor to get stuff checked and this prevents things getting much worse and leading to much higher healthcare costs.

    • jacksparrowismydaddy says:

      @Knock Out sociopaths shouldn’t be in the medical field, they have to have a boss. but if you hate doctors so then next time your sick go see a comedian

    • Anto theja says:

      Wow. Men are the problem in this world

    • Javier Garcia says:

      Watch Grand Hotel tonight on ABC at 9:00 pm on ABC (and you can watch on Hulu)!!!!

  4. Kam Kennicott says:

    it should be said that the guy from the interview about the “pesky hormones” was just a medical historian stating the facts of our shameful medical past.

    • what's it to ya!? says:

      I thought that was clear?

    • TheAureliac says:

      Believe me or believe this video, it’s the present as well.

    • Tim Evans says:

      what’s it to ya!? You never know these days. Before you know it, and angry mob will murder him for even saying β€œpesky hormones” as if those were HIS views

    • greekchick104 says:

      @Tim Evans I think the reason that he would seemingly get hate is because of the language he used (ex: “you” and “me” vs. “men” and “women”). To me, it comes across that it’s making it a little more personal than making it into a general claim. As a female, I see nothing wrong with what he said/the message he was getting across because when looking at it historically, he’s factually correct.

    • dancepiglover says:

      I suspected as much.

  5. mary higgins says:

    My heart breaks for that family. Stories about BeyoncΓ© and Serena almost dying after childbirth scare me to death. All the fame in the world and doctors still won’t believe a black woman.

    • Il Al says:

      Not medical but Oprah Winfrey, THE OPRAH WINFREY, got snark from a saleslady in… Switzerland I think it was, for wanting to look at an expensive handbag iirc. The saleslady thought someone like her clearly couldn’t afford something like that and wasn’t worth her time….. If it’s one thing Oprah has, it’s money. I really don’t think she would have been dressed like a hobo or something either, so the asswipe was just being a racist asshole. Racism fucks with you even if you’re one of the most powerful and well known women on the planet.

    • Colleen Harrison says:

      @Il Al sexism as well

  6. wayward tacocollector says:

    A very effective way to get your doctor to rethink dismissing your claims is to demand they mark down their refusal for tests or declared symptoms in your file. This creates a malpractice paper trail in your record that they can’t obfuscate later.

    • Javier Garcia says:

      A very effective way to get your doctor to rethink is to watch Grand Hotel tonight on ABC at 9:00 pm (or you can watch on Hulu)!!!

    • AKAT1980 says:

      @Nwoke Ideato
      I guess you’re the type of person to keep your mouth shut and deal with the consequences huh?

    • wayward tacocollector says:

      @raglanheuser that’s not how health service claims work either. Taxes, perhaps if the patient has Medicare or Medicaid, but those are set costs and don’t limit the number of scans others can get, outside of scheduling. Again. Advocating for Doctors to document denial of services or symptoms is a good thing. As the old phrase goes, better safe than sorry. I’d rather find out nothing is wrong than allow a potentially fatal disease go undiagnosed. A small cost today can save lives tomorrow.

    • T Haze says:

      I’m an extremely smart guy, but even I never thought of doing this. What an awesome and brilliant idea. I have had doctors refuse to help way too many times.

    • T Haze says:

      @raglanheuser Health care isn’t a zero sum game. That’s just literally not how it works. lol if you think that please go back to high school

  7. ccroque1 says:

    My mom was continually sent home and told she just had acid reflux. She ended up having 2 heart attacks.

    • mwd5233 says:

      idk where you got medical care but generally if they are concerned for a heart attack they draw enzymes (e.g. trops +/- CKMB) in addition to EKG

    • ccroque1 says:

      @mwd5233 Kaiser in SoCal

    • AHart says:

      That’s what they keep telling me. It’s acid reflux and anxiety. I’m concerned I might have heart problems but doctors have f***ed me up so much I don’t trust them. I’m sure they will just say it’s anxiety again and I will have spent my savings on nothing. But bias isn’t just sex and race with the medical community, it’s also age. My husband was having a heart attack and his dr sent him home and later after many hours we made him go to the ER and many hours after THAT and of the hospital saying it’s probably not anything but we have to test to make sure anyways….he had a major blockage in the back of his heart. In a place they like to call β€œthe widow maker.” That was a fun little tidbit the dr had to tell me. They almost killed my husband all because he was 38 and β€œtoo young” for a heart attack. One of the drs at the er kept saying he wasn’t having a heart attack and it definitely wasn’t a heart attack. Thankfully his shift ended and the next dr did the tests.

    • MissMarchHare says:

      Me too…acid reflux, flu, panic attacks….for about 6 mos prior to my actual heart attack. I switched hospitals. It saved my life.

  8. ehla 01 says:

    I’ve already used Larry’s video with my ob/gyn this morning. Thank you, very helpful. My doctor clearly understood him.

  9. staticbb says:

    “these racial disparities exist even when you control for social economic factors…”

    Folks would be mad surprised how often this exact statement pops up when you research anything that makes you feel like you need to ask that question in the first place.

  10. AliEvaMari says:

    I’ve actually been told by a male doctor, regarding pain and bleeding during my second pregnancy, “I don’t think it’s real.”

  11. AliEvaMari says:

    A _human_ should never have to worry that insisting his wife receive proper care will make him “an angry black man.” His story is horrendous. I hope he and his young son find peace within their tragedy ❀️

  12. Please Clap says:

    Telling a woman she’s hysterical when really she’s having an emergency medical issue, is a good way to make her actually hysterical…

    • ChaosLord says:

      I liked your comment, but your profile name and pic are priceless.

    • Megan Simon says:

      That is the point. Project your bias. Gaslight people in desperation so they can confirm your bias. Ignore the humanity from point A to point B. All that matters is you have your “proof” that you caused. That is oppression at its finest.

  13. Sisyphe says:

    Experienced it firsthand. I almost lost an ovary because I wasn’t taken seriously.

    They left me to howl and puke in pain for 3 hours before giving me the first shot of morphine (which just managed to make the pain more bearable) and just shut the door on me because I was being too loud. Then a radiologist who apparently forgot about the existence of ovaries in a woman’s body saw my appendix was slightly swollen (you don’t say) and diagnosed me with an appendicitis. I even overheard a doctor and a nurse (2 males) literally chat about how I was making it up because I didn’t act like I had appendicitis (you don’t say x2).

    The only thing that saved me was a surgeon from another hospital who happened to have an extra shift there. He came to me and said “look, your diagnosis doesn’t add up, I think there’s something more. I’ll have you trasferred to my service. I want to perform that surgery myself ASAP.” He discovered my half exploded/twisted ovary, and patched me up as best he could even though it wasn’t his field. And removed my appendix because… might as well after all, it’s his thing. x)

    Without that man, I’d probably have waited for hours and lost an organ, because y’know, my appendix was just “slightly swollen”.

    *I’m one of the lucky ones.*

    Got another emergency surgery 6 months later, said it was my ovary again, was directed to the closest maternity ward, and finally had the underlying problem fixed for good.

    • dancepiglover says:

      When I had abdominal pain and couldn’t stop throwing up, the first hospital I went to gave me pain medication early on. But once I wasn’t feeling the pain, sent me home and said it was something to do with my intestine. I couldn’t tell you how, but I had it feeling that it had to do with my reproductive organs instead. Later that day the pain came back, but I went to a different hospital. I asked for a second opinion. But they ended up not doing any tests at all, saying the first hospital did it all already. By that time, I was too tired to argue and went home.
      To make a long story short (yeah, there’s a lot more to this story), months later, I finally got surgery (at yet another hospital) and it wasn’t until they had me opened up that they REALLY knew what was going on. I had a benign tumor on my ovary and the weight of it had caused the fallopian tube to twist around like a balloon. The ovary and tube had to be removed. But I had been given the choice to have the surgery or wait and see. Good thing I chose the surgery!

  14. Rah Collier says:

    “I would like to speak to your supervisor,” is not a mating call. It’s a war cry. ><

  15. Care Bear says:

    “Its not my job to tell you what’s wrong with you” no dude, that’s literally part of the job. The other half is fixing what’s wrong with people. Someone take away that idiots license

    • Zondares says:

      No it’s not. You go to an Emergency Room for emergencies only. If it’s not an emergency, an ER is NOT the place to be. An ER doctors role is to stabilize emergencies. If people stopped going to the ER for non-emergencies, stuff like this wouldn’t happen as much.

    • jacksparrowismydaddy says:

      that’s when I demand a different doctor and or that doctors boss.

    • pix says:

      @Zondares I would think having a heart attack qualifies as an emergency.

    • Care Bear says:

      @Zondares yes, where they treat you for what’s wrong with you. Not where they tell you “its not your heart” without any tests or doing anything bc they think you’re “faking” or “overdramatic”. So yes, it is their job to tell you what’s wrong. She was a critically ill patient. It’s their job to treat critically ill patients, not brush them off without testing. Or did you miss the part where he ignored her and sent her on her way saying it wasnt a heart problem when it was?

  16. Amanda R B says:

    Dr had me on edge of suicide because obviously my pain was in my head. I mean. Hes the dr, I’m just a young women. Took a year to find a cyst growning in my spinal column creating irreversible neuro damage. Go dr tran

  17. Trevor Evans says:

    Never realized how much I would love Wanda as a co-host on this show until now.

  18. Yves Oberon says:

    The way to avoid uterine cancer, don’t have a uterus! Well, what diabolical cunning!

  19. littlemissmello says:

    The thicker skin etc. is an old slavery thing I’m afraid. It excused harsher punishments.

    • Il Al says:

      …I thought it couldn’t get worse, and I was terribly wrong D:

    • Compulsive Walker says:

      Most of those wrong assumptions related to black people had their origins strongly connected to slavery. Thicker skin, less sensitive nerves, fast coagulation, etc. These are all related to showing “how blacks are more resistant and able to brush off pain”. It’s also related to the common conclusion that “blacks are brawns over brains, while whites are smarter and more sensitive”.
      It’s terrifying, and even 150 years after the end of slavery, this still is a common belief among society. There’s still much work to be done and racism to be deconstructed in the western world.

  20. swagalicious117 says:

    not to take away from the issue but that nursing book has a point about Hispanics. My grandparents believe in some WACK voodoo medicine stuff. its more of an education/poverty issue though.

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