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Feeling dismissed? How to spot ‘medical gaslighting’ and what to do about it

MAINE — Ms Christina, who lives in Portland, Maine, said she felt ignored by doctors for years. When she was 50 pounds (23kg) heavier, her providers sometimes blamed her body size when she discussed her health concerns.

The experience of having one’s concerns dismissed by a medical provider, often referred to as medical gaslighting, can happen to anyone.

The experience of having one’s concerns dismissed by a medical provider, often referred to as medical gaslighting, can happen to anyone.

MAINE — Ms Christina, who lives in Portland, Maine, said she felt ignored by doctors for years. When she was 50 pounds (23kg) heavier, her providers sometimes blamed her body size when she discussed her health concerns.

One instance occurred weeks after she had fallen off her bike. “My elbow was still hurting,” said Ms Christina, 39, who asked that her last name be withheld when discussing her medical history. She said her doctor waved it off with, “‘Well, you’re overweight and it’s putting stress on your joints.’”

Eventually, Ms Christina visited an urgent care centre, where providers performed an X-ray and found she had chipped a bone.

The experience of having one’s concerns dismissed by a medical provider, often referred to as medical gaslighting, can happen to anyone. A recent New York Times article on the topic received more than 2,800 comments: Some recounted misdiagnoses that nearly cost them their lives or that delayed treatment, leading to unnecessary suffering.

Lately, the problem has been drawing attention — in both the medical community and the general public — for disproportionately affecting women, people of colour, geriatric patients and LGBTQ people.

Studies have found that women are more likely than men to be misdiagnosed with certain conditions — like heart disease and autoimmune disorders — and they often wait longer for a diagnosis.

One group of researchers discovered that doctors were more likely to use negative descriptors like “noncompliant” or “agitated” in Black patients’ health records than in those of white patients — a practice that could lead to health care disparities.

“Gaslighting is real; it happens all the time,” said Dr Jennifer H. Mieres, a professor of cardiology at the Donald and Barbara Zucker School of Medicine at Hofstra/Northwell and co-author of the book “Heart Smarter for Women.”

“Patients — and especially women — need to be aware of it.”

Here are some tips on how to be your own advocate in a medical setting.

Question: What are the signs of gaslighting?

Gaslighting can be subtle and isn’t always easy to spot. When seeking medical care, experts recommend watching for the following red flags.

  • Your provider continually interrupts you and doesn’t appear to be an engaged listener.
  • Your provider minimises or plays down your symptoms.
  • Your provider refuses to discuss your symptoms.
  • Your provider will not order key imaging or lab work to rule out or confirm a diagnosis.
  • You feel that your provider is being rude, condescending or belittling.
  • Your symptoms are blamed on mental illness, but you are not provided with a mental health referral or screened for such illness.

“I always tell my patients that they are the expert of their body,” said Dr Nicole Mitchell, the director of diversity, equity and inclusion for the obstetrics and gynecology department at the Keck School of Medicine of the University of Southern California.

Question: What can you do?

Keep detailed notes and records: Dr Mitchell recommended keeping a journal: “What are your symptoms? When do you feel those symptoms? Do you notice any triggers? If you have pain, what does it feel like? Does it wax and wane, or is it constant? What days do you notice this pain?”

Also, keep records of all of your lab results, imaging, medications and family medical history.

Ask questions: Prepare questions that you would like to ask and be prepared to ask others as new information is presented. If you aren’t sure where to start, Dr Mitchell recommended asking your doctor this: “If you were me, what questions would you ask?”

Bring a support person: Sometimes it can help to have a trusted friend or relative accompany you

Clarify your support person’s role and discuss your expectations, Dr Mieres said. Do you want him or her to take notes, or do you primarily need emotional support?

Focus on your most pressing issue: The average primary care exam is only 18 minutes long, according to a study published in 2021. Dr Mieres recommended taking 10 minutes before your appointment to jot down bullet points that outline the reason for your visit so that you can communicate efficiently.

Question: What if you’re still being ignored?

Switch providers: A study using data from 2006 and 2007 estimated that about 12 million adults were misdiagnosed in the United States every year, and about half of those errors could be harmful. If you are concerned that your symptoms are not being addressed, you are entitled to seek other opinions.

But it’s not always quick or simple to find another specialist who takes your insurance and has immediate availability. If possible, try to get an in-network referral from your doctor.

If you don’t feel comfortable asking your doctor for a referral, you can also speak with a patient liaison or nurse manager. You can also ask friends and family, or call your insurance company to find someone in-network.

Look to support groups: Support groups for many conditions may provide useful resources and information.

Ms Tami Burdick, who was diagnosed in 2017 with granulomatous mastitis, a rare, chronic, inflammatory breast disease, found help from an online group for women with the same condition.

Initially, she was referred to an infectious disease specialist who dismissed a breast biopsy found to contain bacteria.

“I developed horrible, painful abscesses that would open and drain on their own,” Ms Burdick, 44, said.

She conducted extensive research on the disease. And from the support group she learned of a gene sequencing test that could identify potential pathogens. Ms Burdick asked her surgical oncologist to order the test and discovered she had been infected with a specific microorganism associated with granulomatous mastitis and recurrent breast abscesses. It took seven months, but she finally had an answer.

“If the infectious disease specialist had looked further into it,” she continued, “perhaps I could have started antibiotics right away, then and there, and never have required surgery.”

Appeal to a higher authority: If you are being treated in a hospital setting, you can contact the patient advocacy staff. You might also address the problem with your doctor’s supervisor.

Finally, Dr Mitchell said, you may consider reporting your experience to the Federation of State Medical Boards.

“Any instances of abuse, manipulation, gaslighting, delaying diagnoses — those are reportable events that providers need to know about,” Dr Mitchell said. “Doctors need to be held accountable.”

This article originally appeared in The New York Times.

Related topics

Health medicine doctor medical gaslighting medical care healthcare

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