7 tell-tale red flags of medical gaslighting and how it can lead to a horrifying misdiagnosis

• One sign of medical gaslighting is questioning how legitimate your medical history is.
• If your provider doesn't collaborate with you on treatment options, it could also be a red flag.

Medical patients hope to feel safe, heard, and cared for by doctors — but unfortunately, this isn't always the reality.

While gaslighting is a red flag in romantic relationships, the phenomenon often occurs in the medical world too.

"Medical gaslighting is a term recently used to describe when health care providers dismiss a patient's concerns, feelings, or complaints," says Faith Fletcher, an assistant professor in the Center for Medical Ethics and Health Policy at Baylor College of Medicine and a senior advisor to the Hastings Center, a bioethics research institute.

Numerous studies over the years have found examples of medical gaslighting, whether it's interrupting a patient or misdiagnosing them based on unconscious biases about race or gender. Gaslighting in the medical field tends to affect marginalized groups the most.

"These interactions don't take place in a vacuum and are rooted in long-standing structural and social injustices such as racism, sexism, and class oppression in the US healthcare system," Fletcher says.

Here are seven signs your doctor may be gaslighting you and the consequences it can have on your health.

1. They interrupt you

A telltale sign of gaslighting is if a doctor interrupts you during a conversation, says Dr. Alyssa Burgart, a physician ethicist at the Stanford Center for Biomedical Ethics at Stanford University.

A small 2018 study found that on average, clinicians interrupted their patients just 11 seconds into their conversation.

This makes it difficult to get your point across when you're trying to explain why you're seeking medical care in the first place.

"Additionally, when a clinician interrupts a patient, it signals that their time is more valuable than the patient's," Burgart says.

2. They rush you

Whether intentionally or not, doctors may rush your visit.

"Health care providers work under significant pressure to complete complex visits in unreasonably short periods of time," Burgart says.

However, just because a doctor is under pressure certainly doesn't mean they should rush you or withhold their full attention. When a doctor rushes you, they can miss important details about your symptoms or medical history, which can lead to mistakes, oversights, and gaslighting.

A 2020 study found that the average primary care visit lasts 18 minutes. Other survey data from 2018 found that 22% of primary care physicians (almost one-fourth of providers) spent nine to 12 minutes with patients, and 5% spent less than nine minutes.

That said, there isn't necessarily a universally agreed-upon duration that's ideal. What's important is that you feel like the physician has listened to you and worked with you through your various treatment options, Burgart says.

3. They won't discuss your symptoms with you

Doctors may refuse to discuss your symptoms, or blow them off as unimportant, Burgart says.

If a doctor doesn't take your symptoms seriously or won't have a two-sided discussion about them with you, this can lead to misdiagnosis or a delayed diagnosis.

A 2020 study found that one in seven clinical encounters involves a diagnostic error, with 75% of these errors attributed to "cognitive factors in clinician decision making," such as overconfidence in a wrong diagnosis.

Burgart says part of this could be due to the fact that racial and gender biases can cause clinicians to have a preconceived idea of you and what your condition may be.

4. They let underlying biases affect diagnosis

Underlying biases and social constructs such as racism, ableism, and misogyny may cause providers to make errors in their diagnosis.

This can have consequences that are detrimental to health — a 2017 review identified 35 studies that showed evidence of bias in healthcare providers and found that this bias leads to lower quality care.

Here is some evidence of bias leading to delayed or misdiagnoses:

• A 2020 paper found conditions such as cystic fibrosis, Lyme disease, and skin cancer are diagnosed later in Black people than white people.
• A 2019 study found that Black people were more likely to be misdiagnosed with schizophrenia, ultimately resulting in the incorrect treatment for the actual condition they have.
• A 2014 study found women are more likely to be misdiagnosed than men after a stroke.

In fact, Fletcher herself has had personal experience with bias in the medical system. She emphasizes how important it is that we have healthcare providers that understand your lived experience, so there is less of a chance of bias.

Fletcher says it wasn't until she saw her first Black doctor that she understood how physicians should rightfully treat her (and others) in health care interactions –– "with respect, care, and dignity."

5. They say it's all in your head

A step further from not taking symptoms seriously, your doctor might tell you that your symptoms are "all in your head," Burgart says.

Or, they may diagnose you with a mental health condition rather than go on to conduct further testing for a physical issue.

This is particularly common with women, potentially due to lack of funding and research surrounding women's health issues.

"Healthcare providers may take a lack of evidence about women's conditions as evidence that there is a lack of illness altogether," Burgart says.

A 2014 survey of over 2,400 women with chronic pain — a condition that may not present visible symptoms, and therefore is easier for doctors to dismiss — found that 84% of respondents felt like they were treated differently because they were women.

6. They question the legitimacy of your medical history

Particularly in cases where a patient has a long list of medications and allergies, doctors may dismiss or question the legitimacy of their medical history.

"There may be an assumption that anyone with lots of medications and allergies is someone who catastrophizes their conditions," Burgart says.

In these cases, Burgart says it's not uncommon for doctors to write the patient off as dishonest or difficult, which can result in a lack of adequate treatment.

Furthermore, Burgart says while there is an association between allergies and depression and anxiety, some doctors may blame the anxiety or depression and say that the allergies are in the patient's head, rather than consider that there's an immunologic component to mental health.

7. They're uncollaborative on treatment options

Some gaslighting providers may not factor patient perspectives or concerns into treatment decisions, says Fletcher.

Of course, your physician is the expert in the field, but you should also have a say in your treatment plan and understand the process.

Fletcher says this is common when minoritized patients report dissatisfaction surrounding pain management and pain medications, since some doctors may assume minority patients are just drug-seeking rather than actually in need of treatment for their pain.

A 2012 meta-analysis of 20 years of evidence found that Hispanics and Latino patients were 22% less likely to receive opioid pain meds than white patients.

Furthermore, Black patients were 22% less likely than white patients to receive any type of pain meds, and 29% less likely to receive opioid pain meds.

Again, this may be rooted in racism and discrimination.

Insider's takeaway

Medical gaslighting is a problem that ultimately affects patients' mental and physical well-being.

"These well-documented occurrences of patient mistreatment significantly contribute to patients' lack of confidence in the healthcare system and patients' lack of willingness to engage in health care, ultimately heightening inequities in health, especially among populations that are already marginalized," Fletcher says.

You don't have to settle for doctors who gaslight you. If you feel dismissed or belittled by your providers, Burgart suggests seeking a new care team for a second opinion to get the care you deserve.

You can also contact the patient advocacy program at your medical center to help you navigate the situation.