In conversations about medical gaslighting, it’s often too easy for a reductive narrative to take hold. Patients are feeling unheard, unseen, and thoroughly uncomfortable while trying to receive the healthcare they need. So, it’s easy to think that doctors and healthcare providers must not be aware of or must not have an interest in helping combat this phenomenon.
But, of course, that is not the case. Healthcare providers have just as much skin in the game when it comes to navigating (and putting an end to) medical gaslighting as the rest of us. After all, their jobs depend on a certain degree of trust and willingness to seek help from their patients. To further understand the larger systemic reasons different people may encounter medical gaslighting or inequity in the American healthcare system, SheKnows spoke with a few experts about their concerns when it comes to medical gaslighting and what they want to see done about it. Here’s what they shared.
It prevents providers from actually treating health issues
Providers have numerous issues with the idea that their patients might feel “gaslit” in a medical setting. For one, it’s yet another obstacle to providing care that actually treats the pain and illness a patient is experiencing. It’s a barrier to helping people!
“Medical gaslighting is often what happens when we neglect to conduct extensive testing on a patient’s symptoms,” Nancy Mitchell, a registered nurse and contributing writer at Assisted Living told SheKnows. “Many healthcare professionals merely touch the surface: assessing for the most common illnesses without diving deeper into less incidental possibilities. It would be helpful if we conducted assessments beyond the quick physicals; consider the biopsychosocial factors that may also be at play in our patient’s well-being. Different genetic or ethnic backgrounds have higher tendencies to present a certain symptom than others. Sometimes, additional stress from a patient’s environment could amplify the level of pain or distress they experience beyond what’s anticipated for a typical case.”
…and it’s part of a larger tension between profit and high-quality healthcare
Jean Kim, MD, M.A, a Clinical Assistant Professor of Psychiatry at George Washington University cites pressure for physicians to have “rapid, brief, sometimes overbooked appointments” while navigating the billing and legal paperwork, the ability to prioritize patients is challenged.
“This may contribute to patients feeling as though their issues are not being adequately addressed,” Kim says, “because there just isn’t enough time to truly communicate properly.”
It’s a reminder that words have power
“As care providers, we need to acknowledge the power our words have on the psychological health of our patients,” Mitchell says. “Everything isn’t physical.”
Most experts we spoke with agreed that being careful and thoughtful with their words is incredibly important for providers to remember. Recognizing the limits of providers and the research might reassure patients ad help to avoid seeming dismissive or denying the lived experience of a patient.
“Sometimes when patients have mild but persistent symptoms, physicians may use statements that are meant to “mollify” or “reassure” but instead come across as dismissive. We need to be careful with our language,” Dr. Rashmi Mullur of UCLA Health told SheKnows. “We need to learn to accept that we can’t know everything. With Long CoVID, for example, some physicians did not accept or recognize the symptoms that might be associated with this new syndrome, and rather than say ‘I don’t know’ or ‘I’m not sure,’ they may deny or disregard the patient’s symptoms and concerns. We need to accept that patients’ symptoms are real even if they don’t “fit” into the box of standard medical teaching.”
Mullur notes that symptoms are often dismissed when they represent “rare or unreported side effects of medication,” when they “vary from ‘classic’ presentations of an illness” or if they’re otherwise “out of the norm.” Those are opportunities for providers to be especially mindful.
Ultimately, it erodes trust in the healthcare field & further harms vulnerable groups
Dr. Mullur says that as a woman of color and the parent of a “medically fragile, non-verbal child,” she’s experienced more than her fair share of medical gaslighting. The obstacle it poses to getting care, she says, speaks to larger patterns of inequality that exist within our healthcare system.
“I know how hard I have had to fight to get care, and I have been ‘successful’ because I know how to navigate the healthcare system. It shouldn’t have to be this hard and I want to help change the system for our patients,” Mullur says, noting that those who lack her background — and particularly more vulnerable populations like Black people, indigenous people, disabled people, etc. — encounter even greater challenges in not being dismissed by providers. “Our implicit/internal biases in medicine contribute to inequity in care and we must take steps to be anti-racist and anti-discriminatory in medicine.”
And, generally, when these encounters become more prevalent or if they continue to go unaddressed, the odds increase the odds that people won’t fully trust their doctors or healthcare providers when it counts. In the worst possible scenarios, they just won’t seek care when they’re in trouble.
“I can say that denying, downplaying, and/or disregarding a patient’s symptoms or lived experience erodes trust in the medical profession,” Mullur says. “It contributes to trauma experienced by the patient who is trying to seek care. This ultimately becomes an additional barrier to accessing reliable healthcare.”
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