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Acknowledging and Addressing Medical Gaslighting

Acknowledging and Addressing Medical Gaslighting

Laura M. Cascella, MA, CPHRM

“Medical gaslighting” is a relatively new term, but not necessarily a new problem. It refers to situations in which healthcare providers ignore or dismiss patients’ or caregivers’ concerns without appropriate evaluation.1 Although this issue can affect any patient, certain groups are at increased risk, such as people of color, women, people who are overweight or obese, individuals who identify as LGBTQ+, and people who have physical and cognitive disabilities.2

Medical gaslighting can occur for various reasons, but usually it is not intentional (counter to traditional gaslighting, which is a calculated form of emotional manipulation).3 Possible causes include lack of knowledge about certain medical conditions, time pressures, and challenges with medically complex patients. Cognitive biases, which are a well-known factor in medical errors, also may play a significant role in medical gaslighting.

Some cognitive biases that might elicit gaslighting behaviors include:

  • Anchoring, which refers to a tendency to “anchor” to, or rely too much on, a particular piece of information — often the initial information obtained, the first symptom, or the first lab abnormality.
  • Premature closure, which refers to terminating the data-gathering process (e.g., patient history, family history, and medication list) before all the information is known.
  • Confirmation, which refers to the tendency to focus on information that confirms an initial diagnosis or to manipulate information to fit preconceptions.
  • Diagnostic overshadowing, which refers to situations in which clinicians misattribute a patient’s signs or symptoms to any known condition the patient has (whether physical, psychological, or cognitive).

Because most medical gaslighting isn’t intentional, healthcare providers might not be aware of the issue or the potential to perpetuate it. Yet, it remains a growing problem, and ECRI named it as the top patient safety concern for 2025.4 Failure to address medical gaslighting might lead to diagnostic errors, treatment delays, loss of patient trust, avoidance of care, reinforcement of health disparities, and liability exposure.

To increase awareness of this alarming and risky issue and combat it, healthcare organizations and providers may find the following strategies helpful:

  • Cultivate an environment that prioritizes patient trust and well-being and emphasizes patients/caregivers as crucial members of the healthcare team. Leadership support is imperative for setting the tone of organizational culture and raising important issues with staff members.
  • Make sure patients know their rights, how to escalate concerns, how to provide feedback, and how to seek a second opinion if they don’t feel their needs have been met.
  • Raise awareness within the organization about the potential for medical gaslighting and how it can affect the quality of care and patient outcomes. Provide education about the causes of gaslighting and how it’s related to cognitive biases. Consider using simulated scenarios to illustrate examples of gaslighting.
  • Review patient scheduling and address any issues that might prevent providers from having enough time to gather critical patient information, perform adequate exams, and give patients ample time to raise concerns.
  • Engage patients/caregivers in the diagnostic process. Clearly explain the process and encourage patients to provide thorough information about their health and medical histories, ask questions, and follow up on test and laboratory results.
  • Advise patients on how to maintain an accurate medical history and how to think about and discuss their symptoms (e.g., frequency, location, timing, aggravating and alleviating factors, and associated symptoms).
  • Be aware of language that might undercut patient’s willingness to raise concerns and speak openly (e.g., “You don’t need to worry,” “It’s probably just your age,” and “I’m not concerned about that”). Also be aware of language that might reinforce negative patient stereotypes among providers, such as “frequent flyer,” “drug-seeking,” and “substance abuser.”
  • During patient encounters, repeat important information to confirm understanding of the patient’s reason for visiting, their concerns, and their point of view. Allow patients/caregivers to fully voice their concerns without interruption.
  • Ask patients/caregivers open-ended questions (i.e., questions that require detailed answers rather than yes/no responses).
  • Use a team-based approach to support the diagnostic process. Make sure your practice environment is conducive to collaboration and has the technology, structure, and culture in place to support effective communication.
  • Be aware of and increase your understanding of health conditions that have complex presentations, are underdiagnosed, have unclear etiologies, and might be ignored or minimized (e.g., autoimmune disorders, endometriosis, mental health conditions, and pain syndromes).
  • Participate in continuing education that enhances communication, active listening, emotional intelligence, and multidisciplinary teamwork. Additionally, learn about techniques that might help address cognitive biases, such as metacognition, perspective-taking, emotional regulation, and partnership-building.
  • Survey patients to collect data related to their experiences and perceptions. Use the data to identify trends and develop education and solutions to address practice gaps.5

Medical gaslighting is a complex and often overlooked issue in healthcare. As a result, it may erode patients’ trust in their providers and the healthcare system as well as lead to numerous other detrimental consequences. Increasing awareness of this issue and taking steps to combat it can help providers engage patients as partners in their health and deliver high-quality, patient-centered care.

For more information about medical gaslighting, cognitive biases, and the diagnostic process, see the following resources:

Endnotes

1 Ng, I. K., Tham, S. Z., Singh, G. D., Thong, C., & Teo, D. B. (2024). Medical gaslighting: A new colloquialism. The American Journal of Medicine, 137(10), 920–922. doi: https://doi.org/10.1016/j.amjmed.2024.06.022

2 ECRI and ISMP PSO. (2025, March 10). Top 10 patient safety concerns for 2025: Risks of dismissing patient, family, and caregiver concerns. Retrieved from https://members.ecri.org/guidance/risks-of-dismissing-patient-family-and-caregiver-concerns

3 Ng, et al., Medical gaslighting: A new colloquialism.

4 ECRI and ISMP PSO, Top 10 patient safety concerns for 2025: Risks of dismissing patient, family, and caregiver concerns.

5 Ibid.; Texas A&M University. (2024, November 7). Do no harm: Researchers help doctors identify words they should never say to patients. EurekAlert! Retrieved from www.eurekalert.org/news-releases/1064114; DeSanto, L. (2023, September 28). A to Z guide to gaslighting comebacks. HealthCentral. Retrieved from www.healthcentral.com/chronic-health/a-to-z-guide-to-gaslighting-comebacks; Medaris, A. (2022, August 4). I'm a doctor who's witnessed medical gaslighting. Here's how I try to avoid it, and how patients can advocate for themselves. Business Insider. Retrieved from www.businessinsider.com/doctor-mike-how-to-deal-with-avoid-medical-gaslighting-2022-8; ECRI. (2023, September 14). Ask ECRI: Medical gaslighting. Retrieved from https://members.ecri.org/guidance/ask-ecri-medical-gaslighting-6961

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