To be surprised at how shocked I am?

[Hollybollybingbong]

I'd read Invisible Women, Exposing Data Bias in a World Designed for Men byCaroline Criado Perez and realised male symptoms were being incorrectly used to identify illness in women, I thought that was an anomoly.
I've just seen the below petition for Medical schools to include BAME representation in clinical teaching.

Something I'm sure we all imagine happens, teaching how to differentiate symptoms by ethnic groups, simply isn't being done.
www.change.org/p/gmc-medical-schools-must-include-bame-representation-in-clinical-teaching
I knew women were being overlooked, so why am I so shocked that people from a BAME are also being overlooked?

@PlanDeRaccordement

like pulse oximeters don’t work properly on dark skin Only one study found a 1.4% difference in saturation level between lighter skin and darkest skin which was concluded to be not of any statistical difference. And, oh yes, it’s been tested on different skin colours.

At low oxygen levels that is a significant difference. You’ll note they were only tested on dark skin after people with dark skin suffered medical negligence.

PlanDeRaccordement

There are differences in how different ethnic groups respond and react to certain medications. There are many differences in disease processes and risk factors related to morbidity and mortality in different ethnic groups.
It really isn't racist to be aware of this and make efforts to research in order to mitigate these things and give good care to everyone.
Obstetric care for BAME women can only improve if these different risk factors are studied. It is really important.

If you are familiar with John Oliver’s show Last Week Tonight, he did an episode on Bias in Medicine last year - you can watch it for free on YouTube.

It’s about the US, but I’m sure the general problems he talks about are the same here.

Something that really shocked me - he mentioned a nursing textbook that was only withdrawn in 2017, which claimed that Hispanic people were likely to believe that pain was God punishing them.

Well I’m leaving this thread as I’m sickened by the racism apparent in it. No point arguing with a bunch of white people convinced they are some different species of human.

I’ve got the book but haven’t read it - but I will. Then I’ll get my sons to read. One has read quite a lot that CCP’s written and said already.

A few weeks ago on Twitter a young doctor or med student tweeted about something related. I think he was a white Canadian. He was to see a patient with (I think) jaundice. Fortunately looked at the guy’s notes before seeing him and saw the patient was black. For something like jaundice this obviously relevant as the appearance of jaundice on the skin varies according to skin colour. (It might not have been jaundice but it’s a good example of this phenomenon) . Obviously the whites of the eyes will be yellow in everyone jaundiced. Anyway this medic realised all he knew about this condition from training was related to white people and went online to find out more- eventually found info and pictures on a site (or sites?) created by medics who were themselves BAME and who had realised teaching was inadequate. Fascinating and scary.

It's an excellent book and I quote it much.
Currently the skin issues with nurses and N95 masks when looking after patients with Covid 19 are due to the masks being designed for men's facial structure.
I remember nurses I am mental health setting being issues with protective work ware to protect them from attack most were remain. The equipment came from the USA and was designed for the police, the smallest size was ordered and even nurses like me who is 5 ft 8 didn't fit us, we had to abandon wearing them as they were a trip hazard!

Another medical issue is what they used to call Mongolian blue spots - I don't know the technical name, but it's common for babies of Chinese or SE Asian heritage to be born with what look like bruises on their bottoms.

Cue healthcare workers thinking the baby is being abused until somone realises, especially if the mother is of a different race so even HCPs who know of the phenomenon aren't thinking of it.

@PlanDeRaccordement

Well I’m leaving this thread as I’m sickened by the racism apparent in it. No point arguing with a bunch of white people convinced they are some different species of human.

Whereas it's far better to pretend the difference are not real. That'll prove how non-racist you are. Even better you should assume everyone is white and that all difference are due to people being a different species to each other.

Or maybe stop speaking, listen, and learn.

I've read this! Makes for some interesting reading! Shocking but not surprising!

@CherryValanc Interesting MN chose to delete my comment calling out racism, yet allowed Plans racist comment to stand.

Most public health interventions (like trying to get people to lose weight or take care of their diabetes better) -- are heavily mostly women. It's actually a problem to get enough men in most public health research.

That's why I can't stomach reading this book. I get impression it conveniently cherrypicks information to conform with opinions author already had.

eg... N95 facemasks fit men especially badly if they haven't shaved. And even worse if the men have a beard. Does the book say that?

eg., men are about 35% more likely to get pancreatic cancer than females.

Pre-post intervention on treatment option for pancreatic cancer, 57% of participants were male (males are just about properly represented).

I read a tweet by a medical student recently who said about preparing himself for everything about a particular condition, including how the effects looked on skin and then realising when meeting the patient that the text book had only documented what the disease looked like on white skin...

Clearly it's not that white people are some sort of separate species of human. Obviously that's not the case.

Maybe, just maybe, we'd have better outcomes for everyone if medicine wasn't based on the assumption that the default human is a white man. There are all sorts of ways in which current healthcare practice in the UK fails BAME populations (which are reflected in a whole range of health inequalities). And it just isn't good enough.

N95 facemasks fit men especially badly if they haven't shaved. And even worse if the men have a beard. Does the book say that?

Those men can have a shave and improve the fit of the mask. Women can't suddenly alter their bone structure to do the same.