Raise your hand if you've ever left a doctor's appointment feeling confused, frustrated, or ashamed. Chances are you may have experienced medical gaslighting. And lately, people have been speaking out about it on social media.
To find out more about it — including who it impacts and what you can do about it — our “Skimm This” podcast team turned to two experts: cardiologist Dr. Jennifer Mieres, a professor of cardiology and the chief diversity and inclusion officer at Northwell Health, and Karen Spencer, a professor of health and behavioral sciences at the University of Colorado Denver.
What is medical gaslighting?
Medical gaslighting is a type of bias in the health care system. And it can lead to patients not getting the care or treatment they need. “Medical gaslighting means that you're not believed, or your symptoms are belittled, or not taken seriously,” said Dr. Mieres.
It’s existed for decades. And has become systemic due to several factors like lack of research, constraints within the health care system, and discrimination.
Both Spencer and Dr. Mieres pointed out that over the past 100 years of medicine, most funding, time, and attention went into the study of diseases that primarily affected white, cis-gender men. And how diseases all people suffer from affected men. Which has created gaps in how medical providers understand disease today.
Example: Heart disease. As research has expanded across genders, medical professionals have learned that “women can have a spectrum of symptoms,” Dr. Mieres said. But since women don’t necessarily fit the “algorithm” for heart disease, it often gets ruled out.
And according to Dr. Spencer, when you combine those institutional knowledge gaps with the stress of the current health care landscape, you get an epidemic of medical gaslighting. “Our health care system has a lot of time and financial constraints to see a lot of patients in short times,” she said. “And uncertainty or decision-making under pressure can lead to things getting missed or misunderstood.”
Who experiences medical gaslighting?
One report found more than half of lesbian, gay or bisexual survey respondents and 70% of transgender people had experienced discrimination while seeking health care. Which can lead to having to defend or over-explain their reasons for seeking care, according to the American Heart Association.
And according to research from the medical journal Health Affairs, Black patients are over two-and-a-half times more likely to have at least one negative descriptor or stigmatizing language in their medical history and physical notes. Which can affect the treatment they receive from doctors.
“Under-recognition of symptoms leads to undertreatment, and ultimately can have catastrophic effects,” said Dr. Mieres. “It can be lethal in some cases.” Like in the case of women and heart disease. Or in cases of Black women who are pregnant. “You look at the evidence in terms of maternal health, and you see the high rate of maternal mortality among African American women,” she said. “Definitely medical gaslighting.”
What are some signs that I’m experiencing medical gaslighting?
It's important to recognize the "symptoms" of medical gaslighting. Dr. Mieres and Spencer suggested to look for these signs:
Not being listened to or being interrupted. Dr. Mieres said that this is where medical gaslighting starts. And be aware if you start doubting yourself and your concerns.
Questions that go unanswered. Or that get rerouted to other topics.
Irrelevant mentions of weight. “Women and people of color in particular,” said Spencer, “are describing, especially in social media, this very frustrating experience where they go to the doctor to complain about a physical symptom, and are basically dismissed or told that it's psychological, it's all in their head or it's because they're overweight or out of shape.”
How can I avoid being gas-lit by my doctors?
There are a few things you can do to avoid being dismissed in the doctor’s office. First, prep for your appointment by keeping notes of your recent symptoms. “You don't show up to your accountant to prepare your taxes without receipts. You should do the same thing as a patient, because remember, that doctor-patient relationship is really a partnership,” Dr. Mieres said.
And if you feel like you’re not being listened to, try to speak up about it. “Interrupting the process can have a positive effect,” she said. If it doesn’t help, you can try to find another doctor. “Speaking to friends and family to really find someone that will listen to you, that you can build that partnership [with] is definitely critical.”
And according to The New York Times, focus on getting answers to three key questions to make the most of your appointment:
What is the professional's best guess as to what is happening?
How will they diagnose or rule out other possibilities?
What are their treatment options?
Spencer also noted an important element to all of this: This shouldn't be an issue that falls on patients to solve. And many healthcare professionals are working to weed out bias in the system. Medical schools and providers have started to include classes and trainings on effective communication with patients. And have also focused on diversifying the industry at large, so more women and people of color are diagnosing and treating people. And on a national level, according to the National Institutes of Health, there's been a renewed focus on funding studies and research into diseases that affect marginalized groups. But time will tell if those actions will make a difference.
You can listen to more about medical gaslighting here:
Between long-existing bias, certain health issues being underfunded and under-researched, and pressure on the healthcare system, medical gaslighting has become a serious problem for many patients. But some health care professionals are working to change that. And remember to advocate for yourself to get the treatment you need.
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