- The video discusses bias in medicine, particularly in relation to sex and race.
- Women have historically faced judgment and misconceptions about their bodies, leading to biases in healthcare.
- Studies have shown that women are less likely to receive certain medical treatments and pain medication compared to men.
- Medicine has traditionally studied men's bodies as a proxy for all bodies, leading to blind spots in understanding women's health.
- Women have been excluded from medical research trials, resulting in a lack of understanding of how treatments and drugs affect them.
- Bias in medicine can have deadly consequences, such as misdiagnosing heart attacks in women.
- There is also a disparity in healthcare outcomes between black and white Americans, particularly for black men.
- African-Americans have a lower likelihood of receiving recommended care for various conditions.
- Misinformation about African-American patients is prevalent among some doctors.
- Systemic factors contribute to these disparities in healthcare.

- A study found that some doctors hold biased beliefs about biological differences between races, such as black people having thicker skin.
- These biases can lead to differential treatment of black patients, including inadequate pain management.
- Racial disparities in healthcare outcomes, such as maternal mortality rates, exist even when controlling for socioeconomic factors.
- Concrete measures, such as standardizing care and providing bias training for doctors, can help address these issues.
- Increasing diversity in the medical field is also crucial.
- Patients, especially women and people of color, need to advocate for themselves until these changes are implemented.

- The speaker suggests advocating for oneself and bringing a white man to repeat what was said if a doctor ignores you.
- The speaker offers recorded messages from a white friend to use in different medical situations.
- The speaker also provides a white person's seven-word mating call to end conversations with doctors who ignore you.

The video discusses bias in medicine, particularly in relation to sex and race. Women have historically faced judgment and misconceptions about their bodies, leading to biases in healthcare. Studies have shown that women are less likely to receive certain medical treatments and pain medication compared to men. Medicine has traditionally studied men's bodies as a proxy for all bodies, leading to blind spots in understanding women's health. Women have been excluded from medical research trials, resulting in a lack of understanding of how treatments and drugs affect them. Bias in medicine can have deadly consequences, such as misdiagnosing heart attacks in women. There is also a disparity in healthcare outcomes between black and white Americans, particularly for black men. African-Americans have a lower likelihood of receiving recommended care for various conditions. Misinformation about African-American patients is prevalent among some doctors. Systemic factors contribute to these disparities in healthcare. Concrete measures, such as standardizing care and providing bias training for doctors, can help address these issues. Increasing diversity in the medical field is also crucial. Patients, especially women and people of color, need to advocate for themselves until these changes are implemented. The speaker suggests advocating for oneself and bringing a white man to repeat what was said if a doctor ignores you. The speaker offers recorded messages from a white friend to use in different medical situations. The speaker also provides a white person's seven-word mating call to end conversations with doctors who ignore you.

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

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-♪ ♪ -♪ ♪ Doctors, rated number 1 by Reasons There's a Finger in Your Ass magazine.

Doctors have held a position of high esteem in our society for generations, as you can see in the 1930s film, Men of medicine.

City and town, there is 1 house that everybody knows.

Available here are the services of a man who, by law, is privileged to practice the most respected of all professions.

Ah, ah, ah, ah, ah, ah, ah, ah, ah, ah, ah, ah, ah, ah, ah, ah, ah.

♪ Yes, only doctors have the privilege of shoving a stick into a child's mouth and diagnosing a condition that we in the 1930s know as gross throat.

But while medicine may be the most respected of all professions, It is important to know that not everyone has the same experience when they visit a doctor.

I think I would have been treated completely differently if I had been male.

You'll hear doctors and nurses like, -"Oh, they're just exaggerating." -$TRAUMATIC.

You know, and not really listening to them because it's a black person, but if it's like a white person, it's just like, oh, my God, like, this is serious.

If you are a woman and or a person of color in the U.S., you may well have a very different relationship to our healthcare system than a white man.

So, frankly, who better to talk at you for 20 minutes about this than me, the whitest of white men.

Look, I get a sunburn watching the Travel Channel.

I'm a walking cider donut, pale, filled with cake, and found at every farmer's market in the Northeast.

But, but, this is a discussion that we need to have, because while the vast majority of doctors are doing hard work with sometimes limited resources, bias in medicine is a serious issue.

And while it's not the only factor in determining health outcomes, it can have a massive effect.

So tonight, let's talk about bias in medicine in 2 specific areas.

And in the words of every therapist I've ever had, let's start with sex.

Historically, women's bodies have always been fraught with judgment and misconceptions.

Mom, can I go swimming with Peggy tomorrow after school?

No, it's not a good idea the first 2 or 3 days of your period.

It's true, in the 50s, women referred to their period as the curse.

Breasts were the Haunted Mountains, butts were the Valley of Doom, pregnancy was the Happening, and giving birth was called the Babadook.

It was a very, very scary time to be a woman.

And look, things have clearly improved since then, But women can still face an uphill battle to get quality health care.

There are many, many studies showing this.

For instance, they found that women were less likely to be referred for knee replacements than men.

If they're over 50 and critically ill, they were less likely to receive life-saving interventions.

And when going to the ER with urgent abdominal pain, women were less likely to receive any pain medicine.

Just listen to 1 doctor sum up how too many in her profession treat female patients.

I think that a lot of times women's symptoms, especially pain, are attributed to emotional imbalance or, you know, women being hysterical or crying wolf about their pain, and that's absolutely wrong.

The only time it's understandable for a doctor not to hear a woman's complaints about pain is if she's calling into the office and she's got AT&T, because the calls keep dropping out.

I'm airing my dirty diapers in public again.

-♪ ♪ -♪ And look, look, while some of this may have to do with implicit bias on doctors' parts, there is also a systemic problem here, where doctors may literally know less about women's bodies.

Because historically, medicine has studied men's bodies, which here means those assigned male at birth, as a proxy for all bodies.

And as 1 researcher who studied this will tell you, the reason for that was incredibly dumb.

There's this assumption that you are me, with pesky hormones.

The idea is that the fundamental things that are similar between you and me.

So that ironically, the best way to study you is to study me.

Right, we're studying all the fundamental things in you without this sort of nuisance stuff.

Which is why medicine has long chosen to believe that women are just hormonal men.

Also, children are tiny men, dogs are furry men, trees are big, hard, still men, birds are men who can fly, fish are men who can glub, and volcanoes are men who, for some reason, ejaculate lava.

And this idea that women are just men with pesky hormones has led to some woman-shaped blind spots in medicine.

For decades, women were basically excluded from medical research trials, in part because of a concern that their menstrual cycles would complicate the results, which you would think would be all the more reason to include them in tests, because women are half the population and can respond to treatment or drugs very differently.

And in some cases, their exclusion was utterly ridiculous, as this news report from the 90s shows.

In 1990, the Journal of the National Cancer Institute published this report, which looked at the impact of diet on estrogen metabolism and its links to cancer of the breast and uterus.

They studied a way to prevent cancer of the uterus on people who did not have 1.

It's like studying healthy conflict resolution and only surveying the real housewives of New York.

Luan's still pissed off about Dorinda's fish room.

Ramona's turned up uninvited at Barbara's clam bake.

And Tinsley's furious because they all laughed at the fact that she froze her dead dog.

The group's dynamic is still a mess, and the show's all the better for it.

And when you have the male body as the default reference, and doctors who might not take women's pain seriously, the consequences can be deadly.

You're conditioned to think of them looking like they do on TV all the time.

You know, people grabbing their chest and then falling over.

But for many women, that is not what they look like.

Instead, their heart attacks present with subtler symptoms like pain in the back or jaw, nausea, and unusual fatigue.

Just look what happened to Katherine Leon, who went to the ER with serious heart problems and was told this.

The young doctor came in, very condescending, thought I was just a drama queen, and he said, it's not my job to tell you what's wrong with you,

It's my job to tell you what it's not, and it's not your heart." And that was it.

That doctor managed to find literally the only time that telling someone to go home is bad advice.

At a party, stuck next to a guy who wants to talk about Bitcoin?

You're on second and your buddy grounds a single into left field, the outfielder picks it up and throws to first as you round third, but you realize he's overthrown, go home!

But Catherine Leon was having a heart attack.

She should not have been sent home, and she's by no means alone.

1 study found that women who came to the hospital with heart attack symptoms were 7 times more likely than men to be misdiagnosed and sent home from the hospital, which is terrible.

The only thing a woman should be 7 times more likely to do is recognize those Real Housewives references from earlier.

That show is both a nuanced and searing portrayal of wealth, power, and loneliness in Manhattan, or universal themes that should transcend whatever superficial boxes in which it's currently confined.

It's our much ado about nothing, and Andy Cohen is our Shakespeare.

In fact, it's an excellent point, but it's not the point we're making here, which is, sex and gender bias can clearly distort medical outcomes, but they are not the only forms of bias that can do that.

And now, if I may quote the inside of Donald Trump's head, when energy at 1 of his rallies seems to be flagging, let's get to the racism stuff.

Because there is a huge disparity in life expectancy between black and white Americans, particularly for black men.

In fact, when 1 study tried to quantify what is called the mortality gap, they found some shocking numbers, which this documentary chose to illustrate in the most jarring possible way.

We found over 83,000 excess deaths per year in the African-American community alone.

That's the equivalent of a major airliner filled with black passengers falling out of the sky every single day, every year.

But that's such a weirdly specific way to put that.

You don't need to take a number that's already a disaster and put it in terms of another disaster.

It's like 4 double-decker buses driving into each other every 6 hours.

It's 32 hot air balloons exploding every minute for a week.

It's the death of Princess Diana 83,000 times.

Now, clearly, clearly, there are systemic factors contributing to that number, but even just when it comes to contact with the healthcare system, there can be appalling disparities.

There are, again, many studies showing African-Americans have a lower likelihood of receiving recommended care for everything from pneumonia, to hip fractures, to multiple cancers.

And while there's no 1 cause for these disparities, it certainly doesn't help that, as a study of med students and doctors found just 3 years ago, misinformation about African-American patients is rampant.

The study found some doctors believed there are biological differences between the 2 races.

For example, 25% of doctor residents thought blacks have thicker skin.

You do not expect to hear that at a medical school.

You barely expect to hear it yelled across a table by a racist grandfather at Thanksgiving.

His skin isn't thicker than yours, and even if it were, that is not why you didn't vote for him.

And that is not the only insane belief that that study found.

14 percent of second-year med students agreed that black people's nerve endings are less sensitive than whites, which they obviously aren't.

And 17 percent believed that black people's blood coagulates more quickly than whites, which it obviously doesn't.

And at that point, I wouldn't be surprised to learn 86% of them believe that Iris Gis is green on holidays.

Patrick's Day, all holidays, even Yom Kippur.

Now, It is impossible to say exactly where they came by those beliefs, but medical textbooks are not immune from bias.

This nursing textbook was available until just 2 years ago, when it was pulled after it emerged that it featured statements like, and I quote, "'Hispanics may believe that pain is a form of punishment and that suffering must be endured if they are to enter heaven.

African-Americans believe suffering and pain are inevitable, and Native Americans may pick a sacred number when asked to rate pain on a numerical pain scale.

And you expect that a textbook might have typos or outdated information, you do not expect it to basically say, Hispanics think God is kinky, and Native Americans will tell you wizard numbers.

-♪ ♪ -♪ And misconceptions like those can have tangible effects on treatment.

If a quarter of all medical residents think that black people have thicker skin, and nurses have been told that they think suffering is inevitable, that might lead to black patients' pain being treated differently.

And I actually think that Wanda Sykes summed this up best.

Because of racism, black people, we don't even get our hands on opioids.

White people get opioids like they Tic Tacs.

It amazes me how many opioids you motherfuckers have.

You know what they sent my black ass home with?

Okay, Okay, first, from now on, Advil should absolutely call itself Ibuprofen.

1 recent analysis found that black patients were 34 percent less likely to be prescribed opioids for pain than white patients with similar conditions.

And while there are a lot of good reasons to prescribe fewer opioids, my patients are black is just not 1 of them.

And the danger is, if you consistently have bad experiences with healthcare, you might be less inclined to seek help that you need in the future.

Just listen to this woman, who was diagnosed with lupus, describe how she was impacted by the response from doctors when she sought pain treatment.

It was just this belief that I was making things up, that what I was saying wasn't real, that I must be seeking drugs or selling the drugs or some such thing.

And so, what happens is you start to develop a ton of fear around going to the doctor.

Of course you'd be frightened to go to the doctor if you thought they'd treat you like a drug dealer.

I'm terrified of them, and the worst thing doctors ever say to me is, Mr.

Oliver, you're 42 and you should no longer lead to be bribed with a lollipop to get a flu shot.

And look, look, I'm not saying that all doctors are racist or sexist because they obviously aren't.

But people have biases and doctors are people.

And they may have come up in a system that intentionally or not has often discounted the experiences of a major portion of the population.

And their biases, explicit or implicit, have life or death consequences.

And there's perhaps no starker expression of where sex and race can negatively impact healthcare outcomes than maternal mortality.

Currently, the United States has the highest rate of maternal mortality in the developed world, which is already terrible, but it gets even worse for black women.

If you're a woman of color in this country, especially if you're black, your odds of dying in childbirth are 3 to 4 times higher on average in our country.

Because you're not talking about access to health care.

You're not talking about money or education.

We believe black women less when they express concerns about the symptoms they're having, particularly around pain.

But it is worth really underscoring what he just said there.

These racial disparities exist even when you control for socioeconomic factors like education or insurance status.

We are literally disbelieving black women to death.

And that is appalling enough in theory, but it's heartbreaking in practice.

Take Kira Johnson, who gave birth to a son only for things to go horribly wrong.

Her husband said that she waited hours for a CT scan, and by the time doctors took the situation seriously, it was too late.

And to this day, her husband wonders what he could have done differently.

I sit awake at nights thinking, man, like, maybe I should have grabbed somebody by their collar, right?

Maybe I should have turned the table over, right?

I definitely thought about the whole issue of, I didn't want to be seen not only as an angry, but an angry black man, right?

I'm not the smallest guy in the world and What that would mean and how we would be perceived and how we would be Treated as a result of that perception when this first happened.

I would get the question a lot, well, do you think it was because she was black?

Do you think it would be different if Kira was white or was a different color?

And the way I answer that question is, the simple fact that you have to ask that question is a problem.

A woman no 1 would listen to, and a man who feared that if he spoke up, he'd be judged for the color of his skin.

Look, I don't think anyone in their right mind would be comfortable with the idea of someone getting worse medical care because of their race or sex.

So, given that we all agree on that, what can be done here?

Well, ideally, we'd simply figure out a way for no 1 to ever get sick again, thus making trips to the doctor an embarrassment of the past.

You know, like VCRs or MTV giving out something called the Michael Jackson Video Vanguard Award.

But there are also concrete measures that the medical community can take here.

Since 2006, California has cut its rate of women dying in childbirth by more than half.

In part, by instituting protocols for maternal care.

Some hospitals there now do things like quantifying blood loss after birth by gathering the sponges and pads and weighing them on a scale.

That way, the doctor's potential biases are removed from the equation, because if a patient is bleeding too much, the scale will say so.

But that is just 1 example to address 1 very specific problem.

Clearly, we need to think much bigger here, and I know I am just not the best vehicle for this message.

What we really need is someone who can speak with authority from real experience here.

It's just because I was a bit worried that I might be a bit too white to give advice on this subject.

I bet you clap on the 1 and the 3, don't you?

I honestly wouldn't know how else to do it.

Hello, and welcome to Last Sad Tonight with Spectacles McDorky.

OK, look, if you're a woman or a person of color, going to the doctor can be rough.

Been there, done that, got the Ibuprofen.

First, doctors and med students should get bias training.

I know that doesn't sound like fun, but it's 1 of those things that's not fun, but you should do it anyway.

Trust me, you don't want to hear that your child has a reading problem, and it's you.

Second, we need more diversity in the medical field.

We need more non-white doctors in actual hospitals, not just the ones made up by Shonda Rhimes.

And finally, until we do those first 2 things, you've got to advocate for yourself.

And if that doesn't work, don't worry, I've got a backup plan.

Basically, if your doctor's ignoring you, just Bring a white man to repeat everything you said.

And if you're thinking, Wanda, where the fuck am I gonna get...

I've got a white friend who loves complaining to doctors, and he's recorded some messages you can use.

So let's say you're having a heart attack and they're not listening.

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