Amy Faith Ho Profile picture
Mar 25 7 tweets 6 min read
#womenshealth is #disparate because medicine evolved in a patriarchal society. Male presentations of disease are “typical”, female ones are “atypical”. Society becoming more #gender #equal, doesn’t undo the historical bias of medicine we still rely our practice on - as a result,……
While #postpartum care is an obvious example. @American_Heart published that women don’t classically present with chest pain like men in heart attacks, but instead may have fatigue or insomnia. This can be easily written off by doctors as “stress”…
“Stress” is a generous explanation I hear of writing off symptoms. More commonly, I hear “dramatic” or “being extra” as explanations. Those aren’t ICD codes, but implicit biases disproportionately assigned to female patients.
“Bra strap pain” is another classic one — in my anecdotal study of women presenting in the ER with “my bra strap/underwire is too tight” + chest/back pain, 100% positive predictive value for pulmonary embolism. @EmergencyDocs @acog
Pain is also disparate in how it is treated between male and female patients. Punchline: women in pain get dismissed as “dramatic” and get prescribed sedatives rather than pain meds. @washingtonpost…
What does this mean? Medicine still has institutionalized gender biases in #womenshealth that are a disservice to our female patients. #equality “feels” here because med students are now 50/50 gender split, but that hasn’t necessarily made its way to patient care…yet.…
It’s super important to recognize that female pathophysiology can differ from male’s beyond what’s in the underpants. Know to adjust your approach according. Then, teach the next generation of doctors to do the same. #womeninmedicine #womenshealth @acog…

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More from @amyfaithho

Mar 27
A snapshot in time confounded by @TheNRMP match “algorithm”. The truth is #medicine is we have work to do in #genderequity - US physician workforce only 37% women. Rads 27%, Gen Surg 22%, #EM 👋🏼29%…@ACEPNow @WomenSurgeons @AmCollSurgeons @RadiologyACR @EmergencyDocs…
@AAMCtoday stats on 2021 US physicians by % female. #pediatrics 65%, #orthopedics 5.9%. Note surgical sub speciality ($$$) higher male dominance, medical/primary care higher female…#orthotwitter @aap_peds @AAOS1 Image
New generation of US #doctors show progress, by @AAMC study on residents and fellows, 47% total female, #gensurg 46%, #radiology still only 27%, #emed 39%…
Based on the @StanfordMed graphic, we can assume why progress for gensurg but why not for Rads… Image
Read 9 tweets
Mar 27
So what are #PBMs? Chances are, if your meds suddenly got changed by your insurer, or you’ve been waiting weeks on #priorauth for a med you need, or you pay $$$$$ for a drug in the US that is cheap overseas, you’ve already experienced a #PBM and didn’t even know……
That’s b/c #PBMs aren’t meant to be known, they’re meant to be a middleman in healthcare cutting in an extra layer of profit for them and an extra cost to you…wonder why #prescriptiondrug pricing makes no sense compared to prices in other countries? This is why.
Pharmacy Benefit Managers (PBMs) are third party entities paid by healthcare insurance companies to manage all things meds: the formulary (what is/isn’t covered), the price from manufacturer, and the cost (copay or “tier”) to the patient.
Read 9 tweets
Mar 26
Can’t talk about #womenshealth w/o mentioning #maternal death -unfortunately on the rise in does one of the richest countries have the highest rate of maternal & infant mortality?🧵… @acog @ACOGPregnancy
We have high c-sx rates, low prenatal care, high chronic disease rates in our mothers. Post-partum care is a single visit at 6 weeks. Working pregnant moms may opt to induce labor for the 'convenience' of optimizing their leave... Image
Speaking of leave, the US is the one of the ONLY industrialized countries to NOT have ANY paid parental leave. If that doesn't reveal value in a society, I don't know what does. Punchline: the value isn't in family. No wonder our divorce rates and rates of mental health and…… Image
Read 6 tweets
Mar 25
Incredible piece in @propublica on the dark underbelly of #healthcare #insurance — making profit margins off of denying claims (aka healthcare) to its members when they need it most…
If time is money, this is what @Cigna thinks the health of its members is worth: 1.2 seconds Image
It’s not just @Cigna, it’s all the big insurers — @UHC @AnthemBCBS @Aetna - multiple lawsuits filed for the amount of denials they have, but it’s more profitable for them to rampantly deny claims and settle the class action lawsuits later than it is to just do the service they……
Read 6 tweets
Mar 25
Great 🧵- my takeaway since having a 👶🏻myself: if a patient comes to the ER postpartum, DO NOT BLOW THEM OFF. The barrier to leave the house is so high, that if they put on pants to come to the ER, they NEED something. HELP.
Women’s symptoms are often seen as histrionic or atypical at baseline by a medical system grown in patriarchy. Postpartum is one of the most vulnerable times in a woman’s life, so if they seek help, do so, without judgement or barrier.
The issue may be social or a knowledge gap or a lack of healthcare access, but it’s our duty to counsel/reassure/coordinate just as much as it is to treat a classic medical complaint.
Read 5 tweets

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