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Dismissed: Tackling the Biases That Undermine our Health Care
Here's the uncomfortable Race, gender, sexual orientation, age, body size, income, and other cultural factors have a significant bearing on whether you will be diagnosed and treated correctly. The good news is regardless of whether you are a patient, healthcare provider, or administrator, there are steps you can take today to combat medical bias.
The only book on this subject written by a primary care doctor who is a woman of color, DISMISSED examines all forms of bias – those related to race and ethnicity, gender identity and sexual orientation, age, disabilities, obesity, and the increasing bias against science – instructing patients, doctors, and administrators alike on how we can all identify bias – and how we can all do better.
Health-care providers and their patients are human, and all humans have unconscious biases that affect how we listen, observe, and act. Bias impacts patients when they are at their most vulnerable. Health-care bias can mean the difference not just between suffering and relief, but between life and death.
For the first time, an author with the unique perspective of being one of America’s top doctors, a woman, and Black, candidly addresses the issue of bias in health care, sharing personal and patient stories and pragmatic solutions. Dr. Angela Marshall, repeatedly named a “Top Doctor” by Washingtonian magazine, draws on extensive research, poignant stories from some of the thousands of patients she has treated, and her own compelling personal experience, to examine the bias from both patients’ and health‑care providers’ points of view. She offers a bold blueprint for change, filled with fresh solutions that can help everyone in our health-care system.
Dismissed not only explains what so many people feel so profoundly—that the system is working against them. It also reveals what health-care practitioners, patients, and society in general can do to make it right.
The only book on this subject written by a primary care doctor who is a woman of color, DISMISSED examines all forms of bias – those related to race and ethnicity, gender identity and sexual orientation, age, disabilities, obesity, and the increasing bias against science – instructing patients, doctors, and administrators alike on how we can all identify bias – and how we can all do better.
Health-care providers and their patients are human, and all humans have unconscious biases that affect how we listen, observe, and act. Bias impacts patients when they are at their most vulnerable. Health-care bias can mean the difference not just between suffering and relief, but between life and death.
For the first time, an author with the unique perspective of being one of America’s top doctors, a woman, and Black, candidly addresses the issue of bias in health care, sharing personal and patient stories and pragmatic solutions. Dr. Angela Marshall, repeatedly named a “Top Doctor” by Washingtonian magazine, draws on extensive research, poignant stories from some of the thousands of patients she has treated, and her own compelling personal experience, to examine the bias from both patients’ and health‑care providers’ points of view. She offers a bold blueprint for change, filled with fresh solutions that can help everyone in our health-care system.
Dismissed not only explains what so many people feel so profoundly—that the system is working against them. It also reveals what health-care practitioners, patients, and society in general can do to make it right.
304 pages, Hardcover
Published March 28, 2023
35 people are currently reading
2316 people want to read
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Displaying 1 - 21 of 21 reviews
April 8, 2023
Dismissed had the potential to be a hard hitting book. Its author, Angela Marshall, a family doctor who has seen north of 50,000 patients, is hyper sensitive to people being dismissed by “professionals”, such as doctors, as they are, continually. Sadly, the dismissal parts of the book are far outweighed by the rambling justifications of and apologies for the medical fraternity and the standard wishlist for the entire healthcare complex of the USA.
The ways that doctors dismiss their patients is far broader and sometimes more shocking than expected. The stories Marshall has collected of patients “being fired” by their doctors, for say, not implementing the recommended regimen, or of patients firing their doctors for treating them like half-witted morons, are very moving. They occur in several places in the book, a relief from Marshall’s descriptions and (too well known) statistics of the healthcare-industrial complex, all off-topic and of no interest here.
Marshall says she doesn’t think there are more than the average percentages of ignorant, insensitive, biased and bigoted doctors; it just appears that way. Yet she says that a search of Google Scholar brings up millions of hits for “bias in healthcare.” So who is she kidding? Doctors are unfortunately in the god business; they hold the power of life and death. She admits doctors don’t like it when patients come in with their own diagnoses from “Dr. Google”, or if they don’t come in at all so the doctor can’t bill for it. The complaints in defense of doctors pretty much nullifies the dismissals of the title.
Dismissal falls upon a cascading list of minorities. It happens most to Blacks, to women, to other-gendered, the handicapped, the aged, and especially to the poor. It is no secret that the better your insurance and the more money you have, the better doctors will handle your case. As a poor Black woman (0-3), Marshall lost a baby son to an arrogant doctor who refused to be rushed in saving him, despite her reasoning and pleading. Doesn’t get much worse than that.
And bias goes deeper than that; it is ingrained. She cites the fact that 70% of those suffering chronic pain are women, but 80% of pain studies are carried out on men or male mice. Again, not news, but a fine example of dismissing the concerns of women in general.
Another example is native Americans. She cites the fact that the US spends less than half on the healthcare for them than it does for federal prisoners. Figures for Medicaid show American Indians even farther behind the poor. Interesting, but this is not an example of dismissal.
So it’s nothing new and the book keeps veering off course like this. Worse, it gets preachy. At one point, she falls into a trap of her own making, over race. She says that Asian Americans suffer from “all Asians look alike” assumptions, which, she says, “ignores Asian subgroups such as Chinese, Japanese or Korean, important differences that should be understood by health-care providers.” This is so abysmally insensitive as to cast doubt on the whole book. Body shapes, facial features and personality are in no way similar, fewer or restricted in Asians than in whites. Or Blacks. To think of it in terms of nationalities is massively insulting. Very disappointing to read that multiple national origins are the basis for Asians supposedly all looking alike. They don’t. At all.
Nor is it going to get better. Forty percent of first and second year medical students agree that “Black people’s skin is thicker than White people’s,” for example. And this is the next generation of doctors. So it would appear that no one is making headway in raising American children to treat all equally.
Rather than dive deeper into dismissals with perhaps interviews of experts, Marshall flies off on a topline apology for her profession. She says it is a misconception that doctors like to prescribe drugs and that they get paid for doing it. It is just too easy to defeat this argument. She makes several such naïve arguments, where any knowledge of the subject at all could negate her premise. She’s surprisingly superficial. There are endless and repetitive pages on how hard-pressed family doctors are, how they don’t make enough money, see too many patients, are pressured by the healthcare system the same way their patients are, are swamped with paperwork, and on and on. Pity the poor doctors is a large chunk of this book. Larger than the dismissed part.
The enormously disappointing conclusions are just a very long and standard wishlist for change in the American healthcare complex, separated into various constituencies such a patients, doctors, hospitals, insurers, and government. It contain the usual platitudes like “Root out anti-science bias.” Patients need to treat doctors better. Doctors need to treat patients better. Patients need to see a family doctor before going to a specialist. Same for going to the Emergency Dept. More money needs to be spent to fix the system. Got it.
At least, at the very end, she circles back to dismissing: “Dismissal leads to death. I don’t just mean literal loss of life, but also the death of the spirit, the death of dreams, the death of potential. Dismissal damages so many lives: a child with disabilities bullied at school, a worker excluded from a job because of race or gender, a beautiful body hidden in shame after disrespect in social media, a senior whose brilliant ideas are ignored because their hair is white. Each of these dismissals damages a human life. Sometimes that human manages to weld that damage into strength, but at other times we witness the destruction of a person and their potential.” If only she had stuck to this for the other 200 pages, it would have been a challenging and valuable read.
David Wineberg
The ways that doctors dismiss their patients is far broader and sometimes more shocking than expected. The stories Marshall has collected of patients “being fired” by their doctors, for say, not implementing the recommended regimen, or of patients firing their doctors for treating them like half-witted morons, are very moving. They occur in several places in the book, a relief from Marshall’s descriptions and (too well known) statistics of the healthcare-industrial complex, all off-topic and of no interest here.
Marshall says she doesn’t think there are more than the average percentages of ignorant, insensitive, biased and bigoted doctors; it just appears that way. Yet she says that a search of Google Scholar brings up millions of hits for “bias in healthcare.” So who is she kidding? Doctors are unfortunately in the god business; they hold the power of life and death. She admits doctors don’t like it when patients come in with their own diagnoses from “Dr. Google”, or if they don’t come in at all so the doctor can’t bill for it. The complaints in defense of doctors pretty much nullifies the dismissals of the title.
Dismissal falls upon a cascading list of minorities. It happens most to Blacks, to women, to other-gendered, the handicapped, the aged, and especially to the poor. It is no secret that the better your insurance and the more money you have, the better doctors will handle your case. As a poor Black woman (0-3), Marshall lost a baby son to an arrogant doctor who refused to be rushed in saving him, despite her reasoning and pleading. Doesn’t get much worse than that.
And bias goes deeper than that; it is ingrained. She cites the fact that 70% of those suffering chronic pain are women, but 80% of pain studies are carried out on men or male mice. Again, not news, but a fine example of dismissing the concerns of women in general.
Another example is native Americans. She cites the fact that the US spends less than half on the healthcare for them than it does for federal prisoners. Figures for Medicaid show American Indians even farther behind the poor. Interesting, but this is not an example of dismissal.
So it’s nothing new and the book keeps veering off course like this. Worse, it gets preachy. At one point, she falls into a trap of her own making, over race. She says that Asian Americans suffer from “all Asians look alike” assumptions, which, she says, “ignores Asian subgroups such as Chinese, Japanese or Korean, important differences that should be understood by health-care providers.” This is so abysmally insensitive as to cast doubt on the whole book. Body shapes, facial features and personality are in no way similar, fewer or restricted in Asians than in whites. Or Blacks. To think of it in terms of nationalities is massively insulting. Very disappointing to read that multiple national origins are the basis for Asians supposedly all looking alike. They don’t. At all.
Nor is it going to get better. Forty percent of first and second year medical students agree that “Black people’s skin is thicker than White people’s,” for example. And this is the next generation of doctors. So it would appear that no one is making headway in raising American children to treat all equally.
Rather than dive deeper into dismissals with perhaps interviews of experts, Marshall flies off on a topline apology for her profession. She says it is a misconception that doctors like to prescribe drugs and that they get paid for doing it. It is just too easy to defeat this argument. She makes several such naïve arguments, where any knowledge of the subject at all could negate her premise. She’s surprisingly superficial. There are endless and repetitive pages on how hard-pressed family doctors are, how they don’t make enough money, see too many patients, are pressured by the healthcare system the same way their patients are, are swamped with paperwork, and on and on. Pity the poor doctors is a large chunk of this book. Larger than the dismissed part.
The enormously disappointing conclusions are just a very long and standard wishlist for change in the American healthcare complex, separated into various constituencies such a patients, doctors, hospitals, insurers, and government. It contain the usual platitudes like “Root out anti-science bias.” Patients need to treat doctors better. Doctors need to treat patients better. Patients need to see a family doctor before going to a specialist. Same for going to the Emergency Dept. More money needs to be spent to fix the system. Got it.
At least, at the very end, she circles back to dismissing: “Dismissal leads to death. I don’t just mean literal loss of life, but also the death of the spirit, the death of dreams, the death of potential. Dismissal damages so many lives: a child with disabilities bullied at school, a worker excluded from a job because of race or gender, a beautiful body hidden in shame after disrespect in social media, a senior whose brilliant ideas are ignored because their hair is white. Each of these dismissals damages a human life. Sometimes that human manages to weld that damage into strength, but at other times we witness the destruction of a person and their potential.” If only she had stuck to this for the other 200 pages, it would have been a challenging and valuable read.
David Wineberg
October 23, 2022
5 stars
Dismissed
Angela Marshall and Kathy Palokoff
Dismissed is an absolute must-read book for all doctors and patients, as both groups will learn a tremendous amount regarding medical bias and being dismissed. Authors Angela Marshall and Kathy Palokoff explain medical bias in a very alarming yet concise way that should frighten everyone. Because at some point, every single one of us will all be dismissed/ignored as a patient with the potential of real harm occurring due to either intentional or unintentional bias. The stories and statistics detailed within these pages are maddening and unfortunately all too relatable.
This book should be required reading for anyone going into the medical field.
I received a complimentary copy of this book from the publisher and Netgalley.
Dismissed
Angela Marshall and Kathy Palokoff
Dismissed is an absolute must-read book for all doctors and patients, as both groups will learn a tremendous amount regarding medical bias and being dismissed. Authors Angela Marshall and Kathy Palokoff explain medical bias in a very alarming yet concise way that should frighten everyone. Because at some point, every single one of us will all be dismissed/ignored as a patient with the potential of real harm occurring due to either intentional or unintentional bias. The stories and statistics detailed within these pages are maddening and unfortunately all too relatable.
This book should be required reading for anyone going into the medical field.
I received a complimentary copy of this book from the publisher and Netgalley.
July 6, 2023
The premise of this book got me excited! The book itself didn’t capture me. It was great info and a cool first hand perspective from a woman POC doctor, but I didn’t have any “wow” moments that made me feel like I learned something that changed my perspective drastically. All to say, good book, not jaw dropping.
March 11, 2024
This book was in my goodie bag from an author's conference last year, and it's one of the most important I've read.
Author Angela Marshall, MD, is a Black woman who grew up in poverty. Thus, despite being a physician, she herself lives with three of the biases that are most common in medicine.
This book is an outstanding look at both implicit and explicit bias. But Marshall isn't just here to complain; she talks about how programs she implemented in her primary care practice could be expanded to numerous types of health care systems, and advocates for universal health care that would ensure that no one is left behind or financially ruined by catastrophic illness, regardless of their socioeconomic circumstances.
Highly recommmended.
Author Angela Marshall, MD, is a Black woman who grew up in poverty. Thus, despite being a physician, she herself lives with three of the biases that are most common in medicine.
This book is an outstanding look at both implicit and explicit bias. But Marshall isn't just here to complain; she talks about how programs she implemented in her primary care practice could be expanded to numerous types of health care systems, and advocates for universal health care that would ensure that no one is left behind or financially ruined by catastrophic illness, regardless of their socioeconomic circumstances.
Highly recommmended.
July 10, 2023
Great book with lots of insight on the current healthcare system and the bias that runs rampant. Since it’s a nonfiction written by a doctor, it was a little slow and repetitive at times but overall very great book with solutions to our problems.
abandoned
June 11, 2023Dismissed: Tackling the Biases That Undermine Our Health Care
Angela Marshall, M. D. with Kathy Palokoff
307-page Kindle Ebook
Genre: Nonfiction, Health, Science, Disability, Medical Care > Discrimination
Featuring: Vulnerable Patients and Doctors, How Dismissal Can Lead to Death, We’re All Vulnerable, Why Compassion, Empathy, and Respect Matter; The Art and Science of Doctoring, A Prescription for Doctors and Patients, Too Many Are Dismissed, Our Biased Brain, The Threat from Medical Racism, Dismissing Women, Gender Identity, and Sexual Orientation; The Perils of Ageism, How We Devalue People with Disabilities, Dealing with the Shame of Obesity, Complex Challenges to Our Health-Care System, Social Determinants of Health, Science as an Invasive Health-Care Influence, Technology as an Invasive Health-Care Influence, Pharma and Research as an Invasive Health-Care Influence, Payment Systems as an Invasive Health-Care Influence, A Prescription to Fix Health Care, What We Must Do Now, Changing the Future of Health Care in America, Inclusion Leads to Life Request, Discussion Guide, Acknowledgments, Notes
Rating as a movie: Mature for medical trauma
My rating: DNF on page 13, 3rd page of chapter one.
My thoughts: 🔖Page 11 of 307 PART 1 Vulnerable Patients and Doctors - I've only read the introduction, but I already know I'm going to have to force myself through this. It's written in a blah blah manner, but the information is important.
🔖13 Three pages into Chapter 1 How Dismissal Can Lead to Death - I can't do sick babies, and if the worse happens, I'm going to be devastated. I may need to end this journey here.
Why I quit: I don't like reading about terminal illnesses in fiction, so I most definitely am not going to volunteer for nonfiction with terminal newborns.
Recommend to others: I don't know. I think it's an important topic but not for everyone.
Angela Marshall, M. D. with Kathy Palokoff
307-page Kindle Ebook
Genre: Nonfiction, Health, Science, Disability, Medical Care > Discrimination
Featuring: Vulnerable Patients and Doctors, How Dismissal Can Lead to Death, We’re All Vulnerable, Why Compassion, Empathy, and Respect Matter; The Art and Science of Doctoring, A Prescription for Doctors and Patients, Too Many Are Dismissed, Our Biased Brain, The Threat from Medical Racism, Dismissing Women, Gender Identity, and Sexual Orientation; The Perils of Ageism, How We Devalue People with Disabilities, Dealing with the Shame of Obesity, Complex Challenges to Our Health-Care System, Social Determinants of Health, Science as an Invasive Health-Care Influence, Technology as an Invasive Health-Care Influence, Pharma and Research as an Invasive Health-Care Influence, Payment Systems as an Invasive Health-Care Influence, A Prescription to Fix Health Care, What We Must Do Now, Changing the Future of Health Care in America, Inclusion Leads to Life Request, Discussion Guide, Acknowledgments, Notes
Rating as a movie: Mature for medical trauma
My rating: DNF on page 13, 3rd page of chapter one.
My thoughts: 🔖Page 11 of 307 PART 1 Vulnerable Patients and Doctors - I've only read the introduction, but I already know I'm going to have to force myself through this. It's written in a blah blah manner, but the information is important.
🔖13 Three pages into Chapter 1 How Dismissal Can Lead to Death - I can't do sick babies, and if the worse happens, I'm going to be devastated. I may need to end this journey here.
Why I quit: I don't like reading about terminal illnesses in fiction, so I most definitely am not going to volunteer for nonfiction with terminal newborns.
Recommend to others: I don't know. I think it's an important topic but not for everyone.
March 30, 2024
I received this book from Goodreads.com in exchange for an honest review. If I were a physician reading this book, I would have given it 5 stars because it talked honestly how internal biases impact the care that they give to patients. It talked about addressing and working on overlooking those biases when a provider is dealing with a patient. But as a patient, it made me a bit sad because there was no advice to truly be an advocate for yourself when facing a provider that is not listening to you (other than find another doctor). Is there language a patient can use to turn a conversation, so a provider starts listening rather than proceeding with their preconceived biases. I was hoping to receive some of that knowledge as a tool to use when going to a provider, whether primary care or a specialist.
April 25, 2023
I received this book in a goodreads giveaway. I, like many others, are aware of many issues in our healthcare systems. Biases in this field are no big surprise. The author shares her heartbreaking story, and proceeds to give us the cold hard facts.
It does read as a little dry once I got into the meat of the book, but it didn't change the amount of shock I had from the information put forth. If you are at all interested into some insight in the medical field, as to how patients are perceived, and treated (especially by doctors) go ahead and give this a read. However, do take it with a grain of salt.
It does read as a little dry once I got into the meat of the book, but it didn't change the amount of shock I had from the information put forth. If you are at all interested into some insight in the medical field, as to how patients are perceived, and treated (especially by doctors) go ahead and give this a read. However, do take it with a grain of salt.
May 17, 2023
I won this in a Goodreads giveaway. I thought it was very interesting and informative. A lot of good insight from both a doctor and patient’s perspective. I particularly liked that the author wrote it in an easy to understand format and the reader does not have to have a medical background. I think everyone can relate to at least one section of this book.
April 10, 2023
I felt empathy and compassion for the author's personal story, but I felt the book began to ramble and become textbookish, so I quit reading around page 168. I felt like I was in a class and she had already made her point but she kept going. Very good, but very repetitive. Not for me.
April 29, 2023
A little textbook-ish but that's what I expected from this type of book! This book really broadened my understanding of the difficulties everyone in medicine faces with biases including patients and medical providers.
May 2, 2023
Everybody at some point will have dealings with the healthcare system. I recommend this title for anyone who ever in their life felt dismissed, really in any aspect of their lives. Very well written, giving thoughtful insight from both a doctor and patient perspective.
~ Molly
~ Molly
December 27, 2025
This is very much a survey book, which has the advantage of covering a lot but the disadvantage of it's not always the most deep. A helpful starter for people/tie-it-all-together book. Shown the most when she told particular stories of patients.
March 7, 2023
Good insight and research
December 15, 2023
I wanted more from this book :/ I thought it was going to be more textbook vibes with scientific evidence but it was more MHS for dummies with anecdotal evidence
May 25, 2024
Sorry Jayna book club pick 😉
February 18, 2025
Felt redundant, less about tackling the biases and more so just about problems without solutions
This entire review has been hidden because of spoilers.
September 15, 2025
The topic of the book is of great importance, but I feel that the authors just don't really achieve what is promised in the title/summary.
December 12, 2025
Don’t mind me just nerding out
April 25, 2023
It was ok, but I wish it had gone into more depth especially on the serious lack of medical research for women and how the tests and medications many times do not take the female body into account. I know this book was about biases, but if the lack of medical research on the female body isn't a bias, I don't know what is.
Displaying 1 - 21 of 21 reviews