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Our Life | Наше життя May | Травень 2021 21 Also, women tend to underreport symptoms, or to be shy about seeking treatment. Even if they do speak up, they are often not listened to as carefully as their male counterparts. Because of gender biases in medicine, there has been a call for reform in women’s health research and medical education, even since the 1990s. Surveys of trainees illustrate ongoing problems in medical school and residency programs regarding women’s health. In a 2012 Mayo Clinic survey of residents in primary care as well as Internal Medicine, Neurology, Psychiatry, and Orthopedics, 75% of trainees reported rarely discussing gender impact on disease in their education. What’s more, many reported feeling unprepared to practice as a result. The Alliance for a Just Society published a Women’s Health Report Card in 2014 that identified similar issues. In 2017 the American Council of Graduate Medical Education program requirements for graduate medical education in Internal Medicine and Family Medicine found that few programs incorporated women’s health education topics in their residency curriculum. In my own medical specialty of Physiatry (also known as Physical Medicine and Rehabilitation), a cross-sectional survey (published in 2019) of 86 U.S. PM&R residency programs found that only six programs (11%) had dedicated Women’s Health curricula as part of their residency training. The authors (Dr. Bennis and Dr. Rho) recommended that residency programs and their governing bodies consider and correct these shortfalls by adding didactics pertinent to women’s musculoskeletal health. Gender-related disparities extend far beyond clinical settings. A study by Lewis et al ., for example, highlight - ed the disproportionately low prevalence of female physicians and athletic trainers in leadership roles within the National Collegiate Athletic Association. Many conditions are more prevalent in females. Women suffer three times as many migraines as men – and according to the World Health Organization, migraine is one of the top 20 disabilities in the world. Females have two to eight times increased ACL (Anterior Cruciate Ligament) knee injuries in sports. Starting in their 20s, women experience up to 10 times more chronic knee pain than men. They suffer much more crippling arthritis than men (specifically hands and knees) and have many more knee replacement surgeries. In addition, women have high rates of osteopenia, osteoporosis, and subsequent spinal compression fractures. Women have a far higher incidence of autoimmune diseases such as lupus and rheumatoid arthritis. Women also have higher rates of fibromyalgia, chronic fatigue syndrome, chronic pelvic pain and dysfunction, and insomnia or sleep disorders. There are sex differences in common sports injuries. The emerging field of women’s health aligns with the emerging Precision Medicine model, which seeks to customize healthcare so that medical decisions, medications, and treatment practices are tailored to an individual patient rather than taking a one-size-fits-all approach. The Precision Medicine Initiative is a long- term research endeavor involving the National Institutes of Health (NIH) and many other research centers, exploring how a person’s genetics, environment, and lifestyle can help determine the best therapeutic approach to treatment. The Initiative’s short-term goals involve preventative medicine in the area of cancer research – i.e., using genetics and tumor biology to find effective new treatments. The Initiative’s long-term goals are to bring this kind of medicine to all areas of health and healthcare on a large scale. To this end, the NIH has launched a study known as the “All of Us” Research Program, which involves a cohort of one million U.S. volunteers who are providing genetic data, biological samples, and other information about their health. One day we may see medical specialists dedicated to women’s health with precise knowledge of what it means to be a woman. Perhaps there will be a field called “Feminology” specializing in conditions and illnesses particular to women, just as we now have Gerontology, Rheumatology, Oncology, Gynecology, Epidemiology, and Nephrology. It is high time women got the medical attention they deserve. The world will be a better (and, of course, healthier) place when they do. Dr. Podhorodecki is a Board Certified physician in Phys - ical Medicine and Rehabilitation. She holds a certifi - cate in Sports Medicine as well as Electromyography (AANEM). She is an Assistant Professor at the Zucker School of Medicine, Hofstra University/Northwell Health Physician Partners and is a member of the Women’s Sports & Health Initiative for the Katz Foun - dation (Northwell). Her practice is in New York City .
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