Medical gaslighting is a term that refers to The dismissal or invalidation of a patients symptoms, concerns or feelings by a medical professional. The patient isn’t taken seriously, and the healthcare professional does not properly investigate. Instead, they usually attribute the symptoms to being psychological.
After spending time on placement with Jo I felt a common theme emerging from speaking with people with long term health conditions. I felt like most people I met had been pushed aside, not listened to and disregarded at some point. After reaching out to hear people’s stories and examples of when they have been gaslit, I received some responses that were upsetting to read. Individuals had experienced long diagnostic delays due to healthcare professionals not listening or investigating symptoms that were being reported. I heard a lot of frustration and feelings of dismissal. People made to feel like they were making up symptoms for years to then, for example, finally receive a diagnosis of endometriosis. I can only imagine how much psychological suffering this can cause for a person to not be believed for years. This would no doubt, manifest in the body as well as the mind.
Impact of Medical Gaslighting
The repercussions of this type of behaviour from medical professionals is destructive. The main effects include delayed diagnosis. Some evidence from the literature revealed women had a delayed cancer diagnosis and therefore worse prognosis (Popescu & Ciobanu, 2020). Due to delayed diagnosis a subsequent effect was the worsening of a condition that had not been given any attention. Another effect of gaslighting is the mental wellbeing of a person, some people report anxiety, depression, panic, self-doubt, fear and helplessness. Understandably, this culminates in mistrust for a healthcare system that hasn’t listened to them.
Naturally the main questions that surfaced for me were, who is getting gaslit? Why do healthcare professionals’ gaslight? And as a Physiotherapist, what can I do to ensure I do not become part of the problem? In this climate can I arm my future patients with the tools to self-advocate and feel empowered to negotiate this landscape? And yes, it is a shame people need to be armed with such tools for a medical appointment where they are seeking help.
Who is affected?
The literature gives some insight into who is getting gaslit. The main groups are black and ethnic minority groups, women, LGBTQ+ people, elderly people, people with long term/chronic health conditions, people who are neurodivergent and people with diagnosed mental health issues. One example from the literature is a journal article by Leece, 2024** in which people were recruited at random to come forward with their stories of medical gaslighting. Out of all the participants that came forward, all were women, all but one was from an ethnic minority. In a similar study, Eder & Roomaney, 2023 looked into Transgender and non-binary people’s perceptions of their healthcare. Similarly, the findings revealed that medical gaslighting, misgendering and experiences of discrimination in healthcare settings had psychological effects on participants, with reports of dysphoria, self-doubt, fear and a trauma response.
Why does it happen?
It is unclear exactly why a medical professional may gaslight a person. Of course, it’s possible for someone to have an explicit bias which they bring into the patient practitioner relationship. Some suggest that the financial pressures put on practitioners cause a reluctance to investigate patient concerns further. This is a sign of the medical model we see in healthcare, where encouragement for a patient centered approach is laminated on signs and littered in the hallways of hospitals but ultimately, we work in a top-down system that serves to meet criteria and financial targets rather than the needs of the patients – for which we got into the career to help.
More commonly however, it is implicit bias that is operating on an unconscious level interwoven in society and therefore our healthcare system. ‘Medical gaslighting is not simply an interpersonal exchange, but the result of deeply embedded and largely unchallenged ideology underpinning healthcare services’ (Sebring, 2021).
While I was unsure where to start with tackling this issue, I found that reaching out to hear stories led to me receiving helpful resources such as ‘Physio For ME’. This website details incredibly useful info about ME/chronic fatigue for physio’s like me who previously had only heard pacing advice such as ‘Yeah, er just gradually get back to it slowly and take a break here and there’. Physio For ME has free training, FAQ’s for patients and practitioners, blogs, resources for carers and research.
I feel like for healthcare professionals the ‘everyday is a school day mindset’ is underrated, as well as zooming out to remind oneself that the role is to serve the patient and not to serve one’s own ego.
How can we improve?
Some practical ways of helping a person ‘at risk’ of being gaslit could include educating them on what gaslighting is, if they don’t know, and promoting education of their condition, to better help their communication with healthcare professionals. This could be done by prepping for an appointment and bringing a person you trust with you, as well as writing down some discussion topics. Also, asking for clarification if you don’t understand something so they can explain it in a different way, asking to see documentation if necessary or seeking a second opinion if something doesn’t feel right. Joining support groups for your conditions can help to better understand it and converse with people who have been subjected to similar experiences, some of whom would have learned different self-advocacy techniques to help improve care outcomes.
**Leece, H. G. (2024). “Ain’t I A Woman?”: Advancing the Conversation on Medical Gaslighting. The Macksey Journal, 4(1), 25.
Excellent! Some very important issues and questions – I can’t tell you how wonderful it is to have a physio understand and practice with awareness