"Gender-specific adjustments in clinical diagnostics and therapy can be expected"
Gender Medicine: "Gender-specific adjustments in clinical diagnostics and therapy can be expected"
Interview with Prof. Beate Rau, Charité Berlin, Spokeswoman of the "Gender Medicine Task Force"
In Western civilization, equality of women and men has been a topic for many years and is already being successfully implemented in many areas, even if many obstacles still need to be overcome –the introduction of quotas for women in boardrooms, just to mention one of them.
All the more surprising that there is an area where the differentiation between men and women rarely happens – unfortunately, it needs to be said. In medicine, the notion that there needs to be a stronger distinction between the genders in clinical diagnostics and therapy to achieve optimal treatment is only very slowly asserting itself. MEDICA.de addressed this topic with Professor Beate Rau of the Charité Berlin and spokeswoman of the "Gender Medicine Task Force".
Prof. Rau, in most cases, female as well as male physicians don’t consider the gender of their patients in their medical diagnosis and treatment, for instance in the case of a heart attack. Why would that be?
Beate Rau: During their studies, both female and male physicians primarily learn to understand "the one" body and its functions and how to treat pathologies, but they don't learn to take a differentiated approach when looking at a woman’s or man’s body – at least not sufficiently. Attention is usually just paid to the obvious anatomical and metabolic differences, such as the urogenital tract or sex hormones for instance.
Yet it gradually turns out that the differences might carry more weight than previously thought, which is also evident by your task force creation. Can you give us an example from visceral surgery, which demonstrates the differences between the genders particularly well?
Rau: Based on the clinical spectrum of adiposity, the gender-specific relevance to gender difference can be very specifically illustrated in visceral surgery. According to the Robert Koch Institute, two-thirds or 67 percent of men and half of all or 53 percent of women are obese with a BMI greater than 25. What’s more, the different manifestation of adiposity (obesity) in women and men is particularly important. In women, obesity is accentuated in a visceral/intra-abdominal manner and subsequently has more far-reaching consequences than the predominantly excess abdominal fat in men. Another important point is the postoperative development of patients, which is particularly reflected in the length of hospital stay. The results of a retrospective analysis showed that compared to women, men develop a considerably higher level of wound effects during postoperative progress. The causes are presently not yet known, but they could be attributed to a different level of interleukins. Both of these examples illustrate already how important it can be to consider the gender of patients, especially in visceral surgery.
You want to achieve that treatment studies always consider gender-specific differences. When do you think this request is ready to be implemented?
Rau: Our current task in visceral medicine is to research diseases of different organs, for instance the lungs, the gastrointestinal tract as well as the liver and gall bladder in terms of gender aspects. After we collected this data, our work will really start. Studies that analyze these differences need to be conducted. Based on these results, gender-specific adjustments in clinical diagnostics and therapy can be expected. This means it still will probably take one to two decades.
How do you evaluate treatment differences in terms of the physician's gender?
Rau: The gender of the attending physician always plays a role of course. This is by no means a negative thing. Embarrassing topics are often easier to discuss with a person you can identify with. Oftentimes, the patient also looks for certain expected behavioral patterns, empathy for instance, more often expected from female doctors. Nevertheless, I do not agree with the obvious stereotypical statement that female doctors are more empathetic and male doctors more competent. I believe this division in diverging treatment modes between female and male physicians to be outdated and believe that not the gender of the attending physician, but the individual socialization and the character traits of the person, who treats you, play a role.