How To Avoid Medical Gaslighting In Virtual Care
Featuring clinical insights from OpenLoop CMO, Dr. Laura Purdy
If you work in healthcare, you’ve probably noticed the term ‘medical gaslighting’ pop up in conversation or seen it used in industry articles. Or maybe you’ve heard the term ‘gaslighting’ by itself before — but what does it have to do with your medical practice?
This blog will be your guide to ‘medical gaslighting’ and cover what it is, how it relates to both you and your patients and what you can do to prevent it from entering your virtual care practice.
What is ‘medical gaslighting’?
It’s a type of psychological manipulation where an abuser seeks power and control over an individual, often by making them doubt their instincts and perception of reality.
Medical gaslighting follows the same concept and has become systemic due to several factors such as a lack of research, constraints within the health care system, bias and discrimination. It is the action of a healthcare provider understating or dismissing another provider’s or patient's concerns and convincing them that it is either something else or nonexistent. Thus, making the gaslit individual feel like they are overreacting and symptoms go unaddressed.
Clinician vs. patient gaslighting
Unlike other forms of medical bullying, medical gaslighting does not involve overt threats, insults or public humiliation. Rather, it involves subtle and under-the-table interactions. Such as specialists using their status to convince colleagues that the diagnosis they know to be correct is incorrect.
OpenLoop CMO, Dr. Laura Purdy shares her experience from a provider and a patient standpoint.
“I went through my medical training over 15 years ago, and at least, at that time it was common for patients to be referred to as ''crazy” or “frequent flyers,” said Dr. Purdy. “I’ve experienced colleagues express frustration over patients who have symptoms for which causes cannot be found.”
Dr. Purdy even recalls experiencing medical gaslighting as a patient during her third trimester of pregnancy. As a trained physician, she noticed symptoms of preeclampsia appearing and consulted her doctor.
“Even as a doctor, I couldn’t get my clinicians to take me seriously and induce the baby early. It was a really scary time and ultimately I did end up having preeclampsia [but] everything turned out fine. It was terrifying to be in a situation where I knew something was wrong and was being brushed off.”
While symptoms may be hard to diagnose, it’s key that providers take a patient-first approach. This practice protects the provider and ensures patients are treated correctly
Who is affected by it?
Medical gaslighting can affect many people but is found to be associated with mostly women, people of color, LGBTQ+ community and geriatric patients and providers. Women, especially women of color are more susceptible to gaslighting due to systemic biases. Which also hinders a woman's ability to seek redress on the issue.
A medical investigation into the Examination of Stigmatizing Language in the Electronic Health Record found that 2.5% of 49,000 admission notes included stigmatizing language, primarily towards nonhispanic Black patients.
Examples of biased medical gaslighting:
Dismissing heart disease as anxiety
Overlooking autoimmune disorders for depression
Disregarding concerns for weight gain
Stigmatizing language in patient notes
Medical gaslighting is an easily misunderstood concept. It’s important to acknowledge that even good providers can fall victim to this.
Researchers have asked for an increase in training in medical school for unconscious bias and racism in the healthcare industry. In reality, there are numerous social constructs and beliefs, good and bad, within individuals in healthcare. Because healthcare workers have a position of authority with the power to influence a person’s experience and health outcome, the system must acknowledge and take ownership of their contributions.
Promoted discussions and training sessions encouraging bias literacy, such as these techniques listed below, have shown to be effective in minimizing bias:
Diversity, Equity and Inclusion (DEI) representatives
Interpreters and translators
Real-time reporting initiatives of discriminatory behavior
Awareness and Prevention
“Talking about it is key! If we can’t talk about it, then we can’t do anything about it,” said Dr. Purdy. “We need to educate our providers and also educate patients on how to be a good consumer of healthcare. It’s important for patients to learn how to advocate for themselves and it’s also important for clinicians to understand how to have effective engagements with their patients.”
For the clinician
As the patient is speaking, doctors are trained to enter data on the computer. This can leave the patient feeling unheard and devalued as they are broken down to numbers and checkboxes. As a provider, it is pertinent to communicate why and what you are doing so the patient feels involved.
It’s important for clinicians to be aware that this can also be dangerous for them. If a patient feels mistreated or uncared for they may file a malpractice suit. By downplaying a patient's symptoms, a clinician risks misconceived neglect and could be exposed to liability.
Ways to prevent medical gaslighting:
Encourage the patient to share details
Explain the process and reasoning
Why they think a certain treatment would work
How to identify it?
There are many ways to identify medical gaslighting such as:
Are you answering all of the patient’s questions?
Are you listening to or interrupting them?
Are you taking their symptoms seriously?
Are you being respectful or condescending?
Resources and progress
Unfortunately, there are few educational resources out there geared toward reducing causes of medical gaslighting.
“From what I have seen, the younger generation of doctors that are now emerging into the industry, are more compassionate, empathetic and they understand better how to care for patients,” said Purdy.
Clinician resources include:
State Medical Board
Patient advocacy staff
Federation of State Medical Boards
Powering telemedicine for clinicians
OpenLoop, a full-suite, telehealth support company, helps thousands of providers find the jobs they want with our NCQA certified clinician network. We encourage our providers to be aware and diligent with their work and relationship with others. With over 6,000+ clinicians already in our network, you can tap into the OpenLoop advantage with:
Expansive patient network
Sync & async options
Dedicated provider support
Interested in expanding your reach as a provider? Apply to our clinician network!