Individual-level solutions—patient assertiveness training, better symptom journals—are necessary but insufficient. What is required is structural competency (Metzl & Hansen, 2014): the trained ability of clinicians to recognize how institutional policies, reference range construction, and gendered epistemic hierarchies produce diagnostic delays.
Fricker, M. (2007). Epistemic injustice: Power and the ethics of knowing . Oxford University Press.
Jorge, A., et al. (2021). Time to diagnosis in systemic lupus erythematosus: A systematic review. Lupus , 30(4), 531–540.
Within a month, Megan switched majors. It was the first of many courageous decisions.
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Individual-level solutions—patient assertiveness training, better symptom journals—are necessary but insufficient. What is required is structural competency (Metzl & Hansen, 2014): the trained ability of clinicians to recognize how institutional policies, reference range construction, and gendered epistemic hierarchies produce diagnostic delays.