myheartsisters.org

Dr. Fairbanks is an Emergency physician, Professor of Emergency Medicine at Georgetown University and Founding Director of the National Center for Human Factors in Healthcare. This means that, unlike his physician colleagues (and essentially all hospital administration decision-makers, too), Dr. Fairbanks was first known as an expert in human performance, and specifically in how to change systems to make that performance safer by addressing human  error. In the 1970s, when we were trying to reduce human error in aviation and we were using the nuclear industry as our model, aviation experts told us, ‘It’s different – we’re not the same, you can’t apply this stuff to us! Dr. Fairbanks recounts a story to his audience about his early career in safety science, specifically citing a study which found that pilots and air traffic controllers make an astonishing average of two errors per hour n a typical shift:

”), our government-funded health care system pays tens (sometimes hundreds) of thousands of dollars for our cardiac diagnostic tests, emergency procedures, hospital stay, drugs and supplies while in the hospital, and lifelong follow-up with cardiologists, but it often will NOT pay for a proven program like supervised cardiac rehab, despite many studies that show paying for cardiac rehab now will actually save money down the road by improving our cardiac outcomes and helping to prevent expensive hospital re-admissions. That means the highest quality studies have shown that attending and completing a supervised program of cardiac rehab results in better longterm outcomes compared to heart patients who don’t attend. It’s almost as if our provincial Ministry of Health bean counters view cardiac rehab as a zero sum game while they scramble up excuses to deny reimbursement. : I wrote more about these and many more important topics in women’s heart health in my book, “A Woman’s Guide to Living with Heart Disease”

Few women have ideal cardiovascular health, and risk factor treatment remains sub-optimal (1), with substantial disparities in risk factor control in women compared to men, and in African-American women compared to white women (3). Statins reduce the risk of stroke as well as coronary heart disease in women, with similar reductions in overall CVD risk in women and men (7). I wrote much more about addressing cardiac risk factors in my book A Woman’s Guide to Living with Heart Disease (Johns Hopkins University Press, 2017). 2013 ACC/AHA Guideline on the Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adults: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines.

Jennifer Brea is one of those young women who likely shared that expectation that, when her alarming physical symptoms worsened over the course of a year, she would of course be believed by the medical professionals she sought out for help. To help me understand why this might be happening, I looked to Dr. Danielle Ofri, author of What Patients Say, What Doctors Hear, in which she explained what she called that she suspects may be behind this failure to believe women. Patients can experience a physician’s internal bias, as Dr. Ofri suggests, when physicians don’t take their complaints seriously. It’s okay to stop [your doctor] and say, ‘Hey, I’m not sure you’re really hearing what I’m saying,’ or, ‘I feel like you’re jumping to conclusions about what I’m saying before I’ve had a chance to explain.’ “ Q: