I was responsible for diagnosing and treating heart attacks starting from 1974 as an intern and then as a registrar in A/E for about ten years. The range of symptoms given there was very familiar. The fact that some symptoms are more common in women than men made no difference because you had to take note of all of them. If the person was clearly acutely unwell you had to make a diagnosis. A sense of impending doom would be included in that - a clue to pulmonary embolism too, or stroke maybe. Stomach pain occurred in both sexes. An unusual stomach pain of acute onset meant an ECG was done.
So the fact that there is some difference in pattern between sexes is of no real importance. It is a bit like saying to a tailor that it matters that men are taller than women. It doesn't because a tailor is interested in the exact leg length in everyone.
@Jonathan Edwards, each time you write about how you handled specific medical problems and that this was how it was usually done in your professional setting, I think: Yeah, that's how it should be!
But what did you do when you were not sure about a diagnosis? Or did it never happen that you or your colleagues did not find a diagnosis? And did it never happen that your first diagnosis was wrong?
In any case, your descriptions seem quite the opposite of my experience as a patient.
When I try to recall how often I have been treated as a patient in similarly ideal ways your examples describe, these are very rare moments. In particular, few doctors made a proper clinical examination of those parts of my body where I had symptoms, but instead ordered laboratory work, x-ray or MRIs, on which they "found" diagnoses that in the end were ruled out. And I was left with the suggestion that I had been over-diagnosed, so there either could be nothing wrong with me at all or I probably had a psychosomatic condition.
Before I luckily found my current family doctor three years ago, I estimate that 5-10% of the medical encounters I had during the three decades since my early adolescence were professionally accurate practice. This small number most probably is somewhat distorted by selective perception, but put that aside, I could write a book about worst practice examples. For each good medical encounter I recall, an additional bad example pops up. This is distressing, so I won’t write that book.
In any case, all the anecdotes I know from me, my friends and relatives together would be outnumbered by the medical encounters you had with patients during your professional career.
Nevertheless, I think there remains a discrepancy between the examples of invariably excellent medical practice you describe on the one hand, and my and my family's and friends' experiences on the other hand.
Maybe national medical education and practice in the UK and in the past were better than in Germany since the mid-1980s? But could this be a sufficient explanation?
Are you sure, that your medical teachers and colleagues were the rule and not only the better or even outstanding examples? Are you sure the expertise you gained and applied was due to the established national medical education (e. g. textbooks, curricula) and it mirrored the widely shared medical practice at your time in the UK?
Did you and your colleagues already know and practice everything that the proponents of gender medicine have been investigating since the turn of the millennium? Or what do you think about gender medicine as a medical subdiscipline at all?
Apologies for being persistent in this matter, I promise to not ask any further questions about this topic.
(I am aware these might be difficult and too many questions to answer, so if you prefer to answer on the members only section or not at all, I will understand, of course.)