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Alysha Cox

Mrs. Layton

English 1010

4/30/2019

Medical Concerns

Topic Introduction

“Did you wash your hands?” a mother asks, earning a groan from her child. Why do

mothers ask for something so simple it’s almost inconsequential to her offspring? The answer is

simply that hand washing protects against diseases by cleaning away bacteria; there’s no head

turning with that statement-- today. It wasn’t so straightforward in the nineteenth century.

Correspondingly, comes the story of Ignaz Semmelweis, a Hungarian physician in the

1800s, who was determined to figure out why so many women in the maternity ward were dying

of childbed fever. When one of his male colleagues died of the disease, he began to understand

that anyone could contract the disease, and alike, anyone could be a carrier of the disease. So

what did Semmelweis do? He instigated anti bacterial hand washing for doctors and nurses in the

clinic.

Owing to washing away and eliminating germs, the rates of women dying of childbed

fever diminished by 90% (Davis). Remarkable, right? However, the doctors didn’t like being told

they were responsible for the deaths of their patients, and Semmelweis called doctors out in a

matter that rubbed the physicians the wrong way. In turn, the doctors gave up the practice of

antibacterial hand washing because of prejudice, regardless of statistics that argued against it.
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Semmelweis was unable to gain any further ground in convincing physicians of the benefits of

antibacterial hand washing.

Today that story causes grumbling about how people were so obdurate about something

so obviously beneficial. But have things changed? The world of doctors and medicine is ever

evolving to better treat human ailments, however, several current problems are sourced in

community prejudices and ideals, rather than physical outbreaks. These issues are rooted in

social norms, bias, and trust between patients and medical providers, and when society makes

detrimental decisions in these areas, it has a correlated effect on the physical health of patients.

For example, in speaking of social norms and issues, comes the concern as to whether

both genders receive equal health care, and whether they should. Previous clinical studies have

treated men and women congruently, but “today, we know that every cell has a sex,” meaning

that men and women are biologically different down to the smallest levels (Brea, et al.).

Although men and women are similar, they are not necessarily equivalent. Relatedly, many

women complain that their “health concerns [were] downplayed or dismissed by a physician,”

(PagÁn). Thus, some wonder if doctors don’t take women seriously. On the other hand, some

would offer that these complaints should always be taken with a grain of salt. As can be

evaluated, gender differences in medicine and how to work with it, have not found resolution.

In a similar manner, society wrestles with the topic of racism in the medical side of

communities. Even though all humans share a variety of things in common, like two legs and a

nose, there are differences between individuals and groups. Furthermore, sometimes a

questionable shortcut is taken to save on medical costs and time, known as racial profiling. The

idea is that when a patient reveals his or her ethnicity, a doctor can guess problems quicker by
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using statistics created from typical results from subjects of that ethnicity. In using race to make

a diagnosis in a faster manner, Walter Williams proposes that “profiling represents mankind's

attempt to cope with information cost,” (Williams). Those in favor of medical racial profiling

point out how it saves on resources. However, some disagree with this model of testing, saying

that racial profiling in medicine cuts necessary corners and puts blinders on medical test

administrators by making them unable to see the real problems. And so, the racial profiling tug

of war continues, as its benefits and ramifications are weighed.

In addition, another medical issue, more social than physical, is chronic pain. While this

is a disease with painful symptoms, there is no physical ailment that actually causes the pain.

Under current knowledge, “no one understands the cause or causes of chronic fatigue syndrome,

though doctors suspect it has to do with a combination of genetic and environmental factors,”

(Libal, 40). Those suffering from the disease feel foolish because medical tests reveal a

functional body, but the ill patient’s nerves are sending legitimate pain. Basically, those suffering

from the disease argue that they need to be taken seriously by their peers and doctors, and

common knowledge of the disease needs to be broadened.

In emphasis, this topic of recent medical controversies is of consequence because it

affects the health of millions of people. Until these problem areas get cleaned up, patients will

continue to suffer inferior treatment, and unnecessary mental or physical discomfort. Similarly,

large quantities of money are spent on medical care, which “increasingly strains personal,

corporate, and government budgets,” (Henry). Paying for health care and advancement in that

field, costs monetarily both individually and nationally. Current health care problems impact the
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economy on a large, growing scale. It’s salient that consumers of health care feel satisfied with

what they’ve paid for. Thus, these societal problems must find resolution.

Debates and Commentary

Moreover, in regard to these social problems affecting the medical world, the main areas

of controversy are located with the use of medical racial profiling, how gender affects medical

treatment, and society’s response to chronic pain. While hand washing is a no brainer for people

presently, are there present-day metaphorical hand washing situations that society clings to

unnecessarily? This essay will evaluate several perspectives in relation to societal medical

problems.

At the present time, people argue both genders are not currently receiving equal care.

Men and women share many attributes in common, nonetheless, there are many intricate

physiological differences that make equality a difficult quality to measure. Due to these

variances, diseases act differently depending on the gender, and treatment also needs to be

unique. However, when it comes to discerning which remedy would be preferable for each

gender, research habits fall under scrutiny. Some argue that all research should be done gender

specific (Stefanick). Those of this view feel research done with both genders doesn’t help either

gender, and studies should be done with a single gender in mind. Current research is typically

just done with male test subjects, and the information gets applied to both men and women.

While men and women are similar, “The question is, does similarly mean the same?” (Brea,

Jennifer, et al.). Basically, some may argue that the similarities between genders are close

enough for medicines to be administered unreservedly. On the other hand, however, if the
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similarities are not close enough, women are receiving the downside of the research because

studies are done mostly with males.

Similarly, others feel women are at a disadvantage because health care providers don’t

trust female expressions of agitation. These people feel that assumptions are made about female

patients that doctors wouldn’t have assumed about male patient. For example, “doctors and

nurses prescribe less pain medication to women than men after surgery, even though women

report more frequent and severe pain levels,” (PagÁn). Thus, many feel that women don’t

receive adequate aid in relation to their needs, because doctors are doubtful of the genuineness of

complaints. The reasoning behind disbelieving the reality of pain in women, is because it is

assumed that “their pain is “psychosomatic,” or influenced by emotional distress,” (PagÁn). And

so, a doctor takes complaints with a grain of salt, to the much irritation of those sincerely

expressing pain.

In relation to the beliefs of physicians, some argue “A good physician can have biases,”

(PagÁn). Those of this opinion offer that a doctor should be able to hold to their beliefs, as long

as they are willing to take a step back, and explain the reasoning behind their actions. The

opinions and actions of physicians holds one of the greatest keys in resolving social medical

issues. Doctors are paramount in health care, and comparable to the struggle with finding balance

in the treatment for both genders, is the effort of finding balance between treating races.

Furthermore, in diagnosing ailments related to race, some people argue in favor of racial

profiling because “Some racial and ethnic groups have higher incidence and mortality from

various diseases than the national average,” (Williams). Trends have been formulated concerning

tendencies of ethnicities to get certain illnesses, and to some, it makes sense to trust the trends to
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continue. Of course, while using race to predict a patient's risk of a certain ailment isn’t a perfect

shortcut, “there are concrete factual data that surely indicate associations,” (Williams). In some

cases, a patient is suffering from something out of the ordinary for someone of their race; in this

type of case, racial profiling might not speed up the process. But broadly, with a simple

knowledge of a patient’s gender, age, and ethnicity, the physician will have enough information

to predict what a patient is suffering from, and most at risk for (Stephanick). Using this basic

knowledge can save money on performing tests that are costly or uncomfortable, along with

being time and lab consuming. In essence, the argument is that racial profiling offers a legitimate

shortcut, although it is imperfect.

However, the imperfection of racial profiling is a problem for some. Paula Johnson, a

trained cardiologist asks the question,“Why use race when it doesn't tell us anything about our

genes?” (Brea, Jennifer, et al.). Those agreeing with Johnson argue that using a personal pedigree

would be much more effective than the broad idea of race. Those against racial profiling argue,

instead, that the “better way would be to do away with these large social groupings and consider

people's actual ancestry and how ancestry is related to disease,” (Brea, Jennifer, et al.). For those

against racial profiling, they argue that a personal family history of diseases shouldn’t be

substituted with race. Similarly, some emphasize racism is engendered when race is introduced

to a diagnosis, by making patients “vulnerable to harmful biases and stereotypes,” (Brea,

Jennifer, et al.). Racial profiling could cause unequal care by kindling racism in caregivers.

Mostly, people argue against racial profiling medically by voicing that it’s an ineffective shortcut

in comparison to gaining the real data.

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However, gender and race aren’t the only current problem, as society struggles to accept

the reality of the chronic pain syndrome. Many people suffering with chronic pain feel can

disbelieved because chronic pain is real, yet “unreal”. The patient feels legitimate pain in his or

her nerves, but there is no physical problem causing the pain, and correspondingly, “The

condition is often mental as well as physical, as sufferers may also suffer from major depressive

disorder and anxiety,” (Moglia). Thus, chronic pain is intertwined with the physical and mental,

which in turn causes issues socially. But the root of the problem is found in that, without

physical proof of a problem, and with prolonged pain, “Family members and doctors may

become suspicious of the person’s symptoms and suggest that the person is malingering, not

really sick, or imagining their illness,” (Libal 40). Thus, those suffering from the illness feel

constrained by the disbelief of those who don’t understand the problem. Even when they go to

doctors, they may feel mistrusted, as only a minority of medical schools educate about pain,

especially chronic pain, and its treatment (Brea, Jennifer, et al.). So those suffering from chronic

pain have to juggle their illness and how to convince others of the reality of it.

All this leads into the argument that diagnosis needs to improve for chronic pain patients.

The reason diagnosis needs improvement is that “for many people, the pre-diagnosis period of

chronic illness is a time marked by feelings of fear, self-doubt, embarrassment, and

powerlessness,” (Libal, 40). Those suffering from chronic pain feel oppressed by disbelief, and

until an official physician authenticates the problem, they feel pressure to tell the “truth” when

they already are doing so. Therefore, “a correct diagnosis is important not only so a patient may

begin proper treatment, but also so that the patient can understands what he is going through, “

(Libal 40). When a patient understand that there is a real problem causing the pain, instead of
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just a mental breakdown, a greater amount of stability can be found in their lives, and greater

ability to cope with pain and mistrust.

To sum up, these are ongoing problems, interconnected with the community and how

people treat people. It’s becoming more apparent that current views may need to change when

treating illness in relation to gender, race, and chronic pain. It's crucial that the appropriate

solutions are applied to these problems, for the benefit of patients. Until then, people remain

scratching their heads and wondering if a parallel, backward view of handwashing is being held

again.

Areas of Further Inquiry

All things considered, there still a lot of work to be done. For example, some people

argue that doctors need not only to communicate better, but find more effective ways of

formulating a correct diagnosis, which would aid all patients, especially those with chronic pain.

Knowledge about chronic pain is still sparse, and the disease definitely isn’t accepted to be as

real as cancer. Because of this disbelief, those who suffer from chronic pain have to undergo a

painful social diagnosis as an “over exaggerator” or “fallacy teller”. Similarly, official diagnosis

is among the biggest problems related to medical issues with a social side. In short, many hold

that doctors need to learn to become more efficient and accurate in learning and relating what the

problem is.

In continuation of that idea, an important aspect of diagnosis that requires more

measurement and understanding, is how much of a shortcut racial profiling might actually

provide. Racial profiling has been utilized effectively in some cases, but been a hindrance in
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others. Currently, “​research suggest that “racial profiling” in medicine can lead to serious

medical errors,” (​Braun, Lundy, et al.​). If using racial profiling in diagnosis could lead to

medical errors, it has potential to be more costly and painful than having completed

individualized tests at the outset of a medical issue. So it would be imperative for those

researching this issue to determine how likely a racial profiling error is. Similarly, it would be

important to uncover how large scale the error could prove to be in comparison to if

individualized tests were completed rather than using race as a shortcut.​ Depending on the results

and which method proves more expensive, processes may need to be fabricated to cheapen and

ease the diagnosis process, and alternative shortcuts and options explored.

Then, of similar importance and need of further study, is the topic of doctors and their

communication with patients. While many protest that women aren’t taken at their complaint’s

face value, others rebuke that this isn’t unique to just the medical field, or just to women. And so,

many find that it would be beneficial to better understand how humans communicate with each

other and to uncover with more solidity, how to tell when words are expressed with sincerity.

Some patients express pains and problems in a way that has a different meaning to the doctor,

and recent studies have found that “Poor communication skills and a lack of focus on the patient

may affect health outcomes by undermining patient trust and, in turn, patient adherence to

therapy,” (Haider). Communication between patients and physicians has a direct affect on the

care the patient receives. Thus, improved communication skills need to be honed between

patients and physicians so treatments prove effective.

In conclusion, there is still ground to be broken, and studies to be completed concerning

diagnosis and doctor-patient associations, before these issues can be resolved. Many assert that
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societal problems shouldn’t impede the progress of providing better healthcare. These societal

problems do have an impact on money, and those who pay for health care should have

satisfaction with that big sales tag purchase. For those fighting to sort and figure out the correct

answer and resolution concerning these issues rooted in communities, their hope is that greater

success will be found in adjusting current social challenges than was found in Semmelweis’s

attempts to get doctors to wash their hands.

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Works Cited

Braun, Lundy, et al. “Racial Categories in Medical Practice: How Useful Are They?” ​PLoS

Medicine​, Public Library of Science, Sept. 2007.

Brea, Jennifer, et al. “TED Radio Hour.” TED Radio Hour, created by Guy Raz, episode Getting

Better, NPR, 10 Feb. 2017.

Davis, Rebecca. “The Doctor Who Championed Hand-Washing And Briefly Saved Lives.” ​NPR,​

NPR, 12 Jan. 2015,

Haider, Adil H. “Race and Social Class Bias Among Surgical Clinicians.” JAMA Surgery,

American Medical Association, 1 May 2015.

Henry J. Kaiser Family Foundation. "New Technology Is Driving Up the Cost of Health Care."

Medical Technology, edited by Carol Ullmann and Lynn M. Zott, Greenhaven Press,

2013. Accessed 13 Mar. 2019. Originally published as "How Changes in Medical

Technology Affect Health Care Costs—Snapshot," Mar. 2007.

Libal, Autumn. “Chapter 3: THE VISIT.” Chained: Youth with Chronic Illness, Jan. 2004, p. 40.

Moglia, Paul, Ph. D. “Fibromyalgia.” Magill’s Medical Guide (Online Edition), 2017.

PagÁn, Camille Noe. “When Doctors Downplay Women's Health Concerns.” The New York

Times, The New York Times, 3 May 2018.

Stefanick, Marcia. “Sex Differences in Medicine.” Stanford BeWell.

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Williams, Walter E. "Racial Profiling Is a Rational Response to Information." Racial Profiling,

edited by Noël Merino, Greenhaven Press, 2015. Current Controversies. Opposing

Viewpoints in Context. Accessed 12 Mar. 2019. Originally published as "Is Racial

Profiling Racist?" Townhall.com, 19 Aug. 2009.