I walked out of my physician’s office steady and clear in my decision to transfer my care. I didn’t accuse her of anything. I didn’t raise my voice. I simply informed her that I would be transitioning to another clinician within the same concierge program.

She immediately assumed I was leaving for financial reasons and suggested physicians to see outside the system. When I clarified that her administrator had already approved my internal transfer, she told me flatly that I could not switch, despite that approval being on record.

And that exchange wasn’t an isolated misunderstanding. It was the final expression of a pattern I had been experiencing for years.

When my blood pressure continued climbing despite lifestyle changes and a first antihypertensive, her plan was simply to add another medication. There was no discussion of why a previously healthy patient with no compelling history was having progressively uncontrolled hypertension.

I was the one who requested aldosterone and renin testing. Without that request, treatment would have escalated without anyone investigating the underlying physiology.

This moment (like so many others) reinforced what I had experienced across multiple specialties.

Dismissal rarely sounds like dismissal.

Most clinicians don’t tell patients their symptoms aren’t real. Instead, the response is quieter, more subtle:

• “This is probably stress.”
• “It could be hormonal.”
• “Try focusing on weight loss.”
• “Improve your sleep hygiene.”
• “Let’s watch it for now.”
• “Your gums look inflamed, floss more.”

Each comment, individually, is reasonable. Collectively, they replace clinical reasoning. Sadly, there is also a laziness in blaming the patient and going on to the next appointment. They normalize suffering instead of investigating it.

Dentistry: the first missed clue

For years, dentists told me my gums were inflamed and my enamel was deteriorating because of inadequate brushing or flossing, despite meticulous oral hygiene. No one asked why this was happening in a patient doing everything correctly. Only after my celiac diagnosis did those findings make medical sense. By then, irreversible damage had already occurred.

GI: a diagnosis I had to request

With a ferritin of nine, migraines, anxiety, and chronic GI symptoms, I did not receive celiac testing until I specifically asked for it. Even then, there was hesitation. I already had multiple labels of IBS, hypochondriasis, anxiety, and surgical menopause which fit nicely until the ferritin result.

The results were unequivocal. I had celiac disease and it all made sense. The delay was unnecessary.

Primary care: the second major missed diagnosis

For more than a decade, my blood pressure was significantly abnormal in ways that did not match my clinical picture. Yet the workup remained focused on lifestyle interventions:

• Yoga
• Mindfulness
• Sleep improvements
• Weight changes
• Stress reduction

All useful adjuncts, none diagnostic.

Eventually, I requested my own aldosterone and renin levels. The labs returned with my renin unmeasurable, a profoundly abnormal value that should have prompted immediate investigation especially when maxed out on angiotensin receptor blockers which raise renin.

Instead, I received a message stating that my labs were “normal.” Most patients would have accepted that reassurance without question. I didn’t, only because I knew how to interpret the labs myself. I pursued further evaluation. The diagnosis of primary hyperaldosteronism was unmistakable.

Treatment changed everything:

• Blood pressure normalized
• Headaches and migraines disappeared
• Sleep deepened
• Exercise tolerance returned
• The constant pressure in my head and chest lifted

Physiology had been speaking for years. It simply hadn’t been heard.

Why it matters that most of my clinicians were women

Most of the clinicians who minimized or redirected my symptoms were women. I am also a woman. I am also a clinician.

This proves something essential: Gender bias in medicine isn’t about men dismissing women. It’s about diagnostic assumptions the system teaches all clinicians, regardless of gender. The problem is structural, not interpersonal.

Women continue to pay the price.

Research consistently shows that women:

• Are diagnosed later
• Receive fewer diagnostic tests
• Have symptoms labeled psychological
• Must self-advocate more aggressively
• Are referred later to specialists
• Have abnormal labs dismissed at higher rates

I experienced all of this, despite my training. Patients without medical knowledge face even greater barriers.

What clinicians can do differently

• Investigate before attributing symptoms to stress or hormones.
• Never normalize an abnormal lab.
• Don’t let lifestyle guidance replace diagnostic workups.
• Recognize multisystem presentations in women.
• Trust when a patient says something is wrong.
• Ask one more question.

I regained my health because I had the training to challenge what didn’t fit. But patients should not need medical training to avoid preventable delays. We can do better. Women deserve better.

And the next patient shouldn’t have to fight through assumptions to be heard. If the years I lost help even one clinician rethink a reflexive explanation (or empower even one patient to insist on proper evaluation) then those years will carry purpose.

Shannon S. Myers is a nurse practitioner.