It’s not a pact to discriminate, it’s that they’re a high traffic area that tries to quickly treat people through the path of least resistance.
That’s great if you have visible, obvious issues like a missing limb. If you have anything internal though, forget it. The bevy of tests they’ll need to determine anything will take multiple days, so as long as you can still walk with assistance they’ll do their best to shove you out the door and tell you to schedule an appointment with your doc, regardless of how much pain you’re in.
I hurt my knee and I couldn’t walk easily even with assistance. They did x-rays and determined it wasn’t broken and said I probably (and that word is important) just sprained it and I would be fine in a couple weeks. The hospital refused to sell me crutches, and when I said I needed them to walk, they told me I could walk just fine because it wasn’t broken. Several months later and I’m still not better and I’ve been told I probably tore a ligament and I might need surgery. Gee, maybe I wasn’t being a dramatic cry baby after all???
https://www.sciencedirect.com/science/article/abs/pii/S0196064423002676
https://www.washingtonpost.com/wellness/interactive/2022/women-pain-gender-bias-doctors/
Individuals who are intersectional in groups that are under prioritized for health care have it the absolute worst.
https://www.tandfonline.com/doi/abs/10.1080/13557858.2021.1899138
Interestingly I saw one study while pulling this up from 2009 that came to the conclusion that there isn’t a major disparity in pain treatment between races and genders, but I think we’ve learned a great deal about the social determinants of health since then, and these more recent studies and articles show the opposite.
It’s less to do with a pact, and more to do with ignorance. Most clinical signs are taught in north America on caucasian skin (though there’s a really neat clinical guide put out I think by St George’s university in the UK that I highly recommend to all health care providers- it’s called mind the gap and it’s free afaik). Additionally, cultural and language differences change how people raised in different cultures express pain. Finally, women’s health is probably 50 years behind where it should be because any pain to do with female reproductive organs (and by extension abdominal pain) is often written off even when it’s debilitating.
Add in those natural unconscious biases we carry as humans and no universal pact needed, discrimination happens anyway even with people who don’t realize they are doing it.
For anyone doubting these experiences, I am a US medical student, and implicit biases and racism are big topics we are taught and made aware of due to physicians profiling their patient whether intentionally or not.
This is especially common in the ER where many people without PCPs come in for issues that are generally handled by a PCP. One of the more difficult things that physicians struggle with is balancing time with the quality of care they provide to their patients. Profiling makes the “time” component easy, but obviously that results in very poor quality healthcare.
No one should be doubting people’s experiences of racism and discrimination in the ER and beyond. Doctors are people too, and the bigoted behavior you see in other professions are just as likely to appear with your doctor.
