Ms. Treatment : Health: Women have said for years that doctors respond condescendingly to their ailments, and some female patients are refusing to sit still for it. There are signs that change is coming.

All Jody Wilson Crooks wanted was information from her physician about the surgical procedure he said she needed.

What she got instead, she says, was a “cold, arrogant response” along with a threat that he would no longer be her doctor if she didn’t go along with his recommendation.

“Initially, I did what a lot of women do: I kept asking myself if I said something wrong, if my tone of voice was off or if I broke some rule I wasn’t aware of,” said Crooks, a Ventura engineering company administrator.

“But then I got angry,” she said. “I’m the person who makes the decisions in my family about where we go for medical care, and I don’t have time to wonder whether my questions are threatening to a doctor. I wrote him a letter and told him I was going to find another doctor who would treat me like an adult.”

Crooks’ response appears to be an increasingly common one.

“I think more and more of what we’re seeing is: ‘You don’t understand, and I’m tired of trying to explain it to you,’ ” said Gwen Lauterbach, community educator for Ventura County Planned Parenthood. “A lot more women are getting angry at doctors who don’t take them seriously. They’re saying, ‘I’m not going to put up with this treatment anymore.’ ”

Women’s health advocates say a common complaint over the years has been that medical professionals often do not give women the time or attention they deserve, and dismiss their physical complaints as being emotional in nature. They cite abdominal pains treated with tranquilizers, concerns about menopause met with advice to get a job, questions about medical options interpreted as an insult.

Other women say they have been made to feel like an unwelcome intrusion on their doctor’s day.

“I was taking time off from my work and had to wait an hour to see him, and all he said was, ‘It’ll pass,’ like it was all in my head,” said Anne, a 42-year-old Thousand Oaks woman who didn’t want her last name used. “His whole attitude was: ‘Make it quick--I have a roomful of patients and a golf game to go to.’ That kind of thing has happened to me more times than I can tell you.”

But the days when doctors can expect a woman to act like an eager-to-please schoolgirl--blithely accepting a dismissive attitude as an unavoidable part of her care--may be coming to an end.

Studies in recent years have given credence to the idea that women’s health care in the United States has been anything but equal to men’s. Documented gender disparities in medical treatment, diagnosis and research now are so pronounced that the American Medical Assn. recently issued a report calling the disparities “a cause for concern that needs to be addressed by the medical community.”

As a result, many women say they are rethinking the kind of medical care they receive.

“More than just being discounted, I just think a lot of women are realizing that they’ve been fluffed off,” said Deborah Sargent, a nurse practitioner with the Lindsay Center for Women’s Health in Simi Valley. “They come here because they say the doctor had one foot out the door or that they didn’t get a full explanation. It’s kind of like going to a mechanic who listens to your husband but not to you.”

Lauterbach said she isn’t surprised by studies showing that women often receive the short end of the medical stick. Women have known all along that they weren’t taken seriously, she said. They just couldn’t prove it.

“Women’s experiences have been negated,” she said. “Just look back through medical textbooks and magazines. One ad for tranquilizers has a picture of a middle-aged woman yelling at her husband and it says: ‘Get her off his back.’ That’s typical.”

There are indications that the government and the American Medical Assn. are beginning to respond to allegations of bias and stereotyping within the medical community.

The National Institutes of Health is now required to include women in any pertinent study and has added a women’s health division. Among other things, the division will undertake a first-ever investigation of commonly prescribed hormone-replacement therapies. The results, however, are not expected for at least 10 years.

The AMA recently launched a women’s health campaign to encourage doctors to listen more attentively to their female patients and provide them with more information. And an increasing number of medical schools around the country are making mandatory a type of “Bedside Manners 1A” course, designed to help doctors become more sensitive when communicating with patients. Those courses, however, do not distinguish between male and female patients.

Locally, there have also been some changes.

Two years ago, Westlake Medical Center in Westlake Village joined the growing number of hospitals nationwide that have set aside an area solely for women’s health concerns. The Women’s HealthPlace now offers treatment and education on everything from mammography and menopause to nutrition and stress.

“We’re trying to focus on the whole woman,” said Jane Kelly, the center’s program manager.

Following suit is Simi Valley Hospital, which is creating a women’s resource center to provide information on women’s health issues. Community Memorial Hospital in Ventura also has plans to build a “women’s health pavilion,” although a hospital spokeswoman said construction probably won’t start for another two years.

But while the idea of being catered to may be viewed as a nice change, many women say they aren’t completely sold on hospital-based women’s centers. Some say it is a matter of preferring a smaller, private practice, while others express skepticism about the sudden push by hospitals to meet their every need. “I think a big part of it is marketing,” Lauterbach said of the hospital-based women’s centers. “Health care is a business today, and if statistics say women are the way to go, that’s what they’ll do.”

Statistics do say women are the way to go. According to the American Hospital Assn., as much as 70% of health care decisions in families are now made by women. Part of that may reflect the growing number of women in the work force who have their own medical insurance, but marketing surveys also have shown that hospitals that attract women as patients will do better at bringing in other family members for services.

“That’s what floors me about so many doctors,” Crooks said. “You’d think they’d know that, too. I choose the pediatrician. I nag my husband to make an appointment. I make sure the medical bills are paid. You’d think they’d pay more attention to us.”

Which brings up the issue that still is foremost in the minds of a lot of women: What will it take to change the attitudes of a lot of physicians?

Paulette Beakley, a 47-year-old Camarillo resident, thinks it is taking too long for the studies to have a trickle-down effect on the behavior of male doctors toward their female patients.

“Doctors have to realize that a pill and a pat on the back and telling them to go buy a new dress just won’t do it anymore,” Beakley said.

Beakley said she has had her share of bad experiences with doctors. One, when she sought help for menopausal symptoms, advised her to get a job because she was probably just bored. Another counseled her to take a vacation because she was probably just stressed.

“I wanted to slap them,” she said.

Instead, Beakley did what a lot of women around the county are doing. She sought medical care from another woman.

“The first thing she said was that I wasn’t crazy and that she was going to treat me,” Beakley recalled. “It was such a relief that I just started to cry.”

Dr. Josephine Soliz, a family practitioner in Oxnard, said she has seen other women like Beakley. She said many patients tell her their concerns have been discounted by other doctors, or that their questions were met with borderline hostility.

“Unfortunately, it’s not uncommon,” Soliz said. “My feeling is that the doctors who act that way are taking it (the questions) as a personal attack. It comes out of that paternalistic thing of ‘I know what’s best.’ ”

But Dr. Michael Williams, a Camarillo general surgeon, said he understands what would prompt some doctors to act defensively.

“It’s not an ego trip as much as it is a threat,” Williams said. “The patient is threatening you by asking about the alternatives.”

Williams heads the Ventura County Medical Society’s Mediation Committee, a group designed to review complaints against local doctors. Riley McWilliams, the society’s executive director, said that many of the complaints focus on bad attitudes and poor communication skills.

The medical society had no statistics on the number of complaints filed specifically by women. But other studies show that patient dissatisfaction in general is widespread. A 1990 survey conducted by a major pharmaceutical firm found that one in four Americans had switched doctors at least once because the doctors made them feel uncomfortable. Another survey showed that 70% of malpractice claims resulted in part from a doctor who communicated poorly and upset his patients. Neither study, however, classified respondents by sex.

Williams agrees that some male doctors may not take the time with women that they should. He even concedes that in his earlier days, he was occasionally guilty of a how-dare-you-question-me response to patients.

But he also said he doesn’t think male doctors in general have a problem with communication. And female doctors, he said, don’t have any magical ability that their male counterparts don’t.

“I have seen articles in medical literature that implied that women doctors are not a hell of a lot better than men doctors as far as their relationships with patients are concerned,” he said.

Williams said he was unaware of national studies showing gender-based medical discrepancies. But he insisted that he has known of no patient who has ever received less care--or less caring--simply because she was a woman.

“I’ve seen many patients who were underdiagnosed, but it wasn’t because of their sex,” he said. “They had just had a slam-bam-thank-you-ma’am kind of diagnosis. The doctor grabs the chart, shoots in to see you, tells you your pain is just the flu--and it’s really ovarian cancer that goes another month without diagnosis.”

It is precisely that kind of attitude that women like Crooks are trying to change. And they say if doctors today don’t want to provide them with the care and information they want, then they have a solution.

“I’d like these doctors to know that they need to pay attention to us,” Crooks said. “If we don’t like the way they treat us, we’ll go somewhere else. They may not care about losing one patient, but there will be more.

“I have a lot of friends in town. And believe me, a lot of them will hear this doctor’s name.”

ALL ISN’T WELL

Women have voiced the feeling for years that many doctors have not taken them seriously. Their husbands have been given treadmill tests and cardiac risk assessment tests; but when they have complained of chest pains, they have been told to take a vacation.

Now an increasing number of studies support the idea that all is not well in women’s health care:

* One study, released in 1990 by the American Medical Assn., found that women were more than twice as likely as men to have their coronary complaints attributed to psychiatric causes. In cases involving abnormal coronary test results, the same study revealed that 40% of male patients, but only 4% of women, were referred for further testing.

* Although men and women with similar smoking practices have essentially the same risk for lung cancer, a 1988 study published in the American Journal of Epidemiology found that physicians are twice as likely to order diagnostic lung tests for men as they are for women.

* A six-year study, published in 1988 in the Archives of Internal Medicine, found that male dialysis patients have a 75% greater chance than women of receiving a kidney transplant. Women are less likely to receive kidney dialysis, the report said, despite a government agency’s assessment that female dialysis patients have a slightly better survival pattern than males.

* A 1983 study published in the Journal of Family Practice found evidence that physicians are more likely to perceive women’s maladies than men’s ailments as being the result of emotionality. Women’s statistically greater use of the health care system also has been attributed to “overanxiousness.”

* Medical studies on issues such as cardiovascular disease and the effectiveness of new medications have historically been conducted almost exclusively on men, according to a 1990 study that was published in the Journal of the American Medical Assn. The resulting lack of information about women--including how their menstrual cycles may affect their response to certain medications--”may affect diagnostic and treatment indications for women,” according to the authors.