Women Less Likely to Get Pain Relief in Emergency Rooms: 'Troubling Bias'

Emergency departments in Israel and the United States are reportedly less likely to address women's pain adequately compared to men.

A study of over 21,000 admissions into ER departments across the two nations found the problem to be systemic.

Researchers describe the problem as concerning, noting "pain management decisions in emergency departments disfavor female patients compared to male patients."

Women are not only spending longer in the hospital, they are also less likely to have their pain levels recorded, and are frequently discharged without appropriate medication, according to the research.

"Our research reveals a troubling bias in how women's pain is perceived and treated in emergency care settings," said The Hebrew University's Professor Shoham Choshen-Hillel, in a statement.

People visiting ER for issues major and minor should be familiar with various pain scales used to assess the need for treatment.

Basic pain assessment tools feature a scale of 1-10, often accompanied by pictures.

This method allows the patient to describe every sensation, from mild discomfort to complete agony. In numerous cases, a "consistent sex disparity emerges."

Female patients with relevant issues are less likely to receive treatment for every pain score and at every age group, according to the study.

Doctors are 10 percent less likely to ask female patients to score their pain for serious issues, the study found.

Other scenarios noted in the research include staff not deeming it important to record the pain figure in the context of their treatment.

Women are also less likely to receive a prescription for any type of analgesic relief, both opioids and nonopioids, compared to male patients.

The team responsible for this study suggests these issues could lead to inadequate treatment.

A man and woman with the exact same condition—a foot fracture ranked 7/10, for example—could be treated very differently, according to the study.

"This under-treatment of female patients' pain could have serious implications for women's health outcomes, potentially leading to longer recovery times, complications, or chronic pain conditions," explain Choshen-Hillel.

Interestingly, whether the patient was being treated by a male or female practitioner didn't make a difference in the care.

Both male and female doctors are doing the same thing with regards to treatment, which the researches says suggests the problem is pervasive across the medical profession.

There were also problems discovered with the manner in which patients are being triaged.

A controlled experiment involving 109 nurses showed the nurse's opinion of their patient's pain was rated as less intense if the patient was female, even in spite of the information available to them.

The study suggests that the research shows women's pain is often not treated properly in medical settings.

Recommendations have been made to train health care professionals to help them recognize and address gender biases.

Other suggestions include for pain management guidelines be reviewed and standardized, in order to provide fair and effective treatment for all patients.

References

Guzikevits, M., Gordon-Hecker, T., Rekhtman, D., Salameh, S., Israel, S., Shayo, M., Gozal, D., Perry, A., Gileles-Hillel, A., & Choshen-Hillel, S. (2024b). Sex bias in pain management decisions. Proceedings of the National Academy of Sciences, 121(33). https://doi.org/10.1073/pnas.2401331121