ADMIN & CLINICAL OPERATIONS
Addressing Sexism in Emergency Department Operations SAEM PULSE | NOVEMBER-DECEMBER 2022
By Tehreem Rehman, MD, MPH on behalf of the ED Administration and Clinical Operations Interest Group
12
The Role of Sex and Gender in the Patient Experience Disparities in Care Delivery
Significant disparities in care of women continue to exist, such as with respect to pain management, diabetes care, and treatment of acute coronary syndrome. Gender disparities in pain management could be partially attributed to the stereotypical view of women over-reporting or exaggerating their pain symptoms. Within diabetes care, “women with type 1 diabetes have a 40% higher excess risk of premature death than men with the disease, and those
individuals with type 2 diabetes have up to 27% higher excess risk of stroke and 44% higher excess risk of coronary heart disease.” There is concern that “many drugs used in patients with diabetes have different adverse effects in men versus women — particularly for outcomes such as fractures and urinary tract and genital infections — which might affect adherence, yet guidelines rarely offer sex-specific recommendations on treatment.”
care such as with women less likely to be prescribed aspirin, statins, and ACE inhibitors compared to men. Researchers have also found that women found to have a STEMI have higher mortality rates than men with results suggesting “Sex difference in mortality following STEMI persists and appears to be driven by prehospital delays in hospital presentation. Women appear to be more vulnerable to prolonged untreated ischemia.”
With respect to management of cardiac risk factors, there are known sex differences in the prescription of cardiovascular medications among patients at high risk or with established cardiovascular disease in primary
Patient-Physician Gender Discordance
Patient-physician gender discordance can exacerbate these disparities. For instance, one study demonstrated
