Contributor: Laura Nozicka
To learn more about Laura, click here.
What do patients really want from healthcare? It’s not always a cure. More often, it’s to be heard.
As host of “The Desperate for a Diagnosis Podcast” and a longtime healthcare qualitative market research moderator, I’ve interviewed hundreds of patients, many of them women and members of marginalized communities. These patients are not leaving health systems because of poor outcomes. They are leaving when they feel dismissed, invalidated, and emotionally abandoned by the very professionals meant to help them heal, an experience known as medical gaslighting.
“Medical gaslighting” can be defined as “…an act that invalidates a patient's genuine clinical concern without proper medical evaluation, because of physician ignorance, implicit bias, or medical paternalism… Ultimately, most of the undesirable gaslighting behaviors are driven by systemic constructs and biases.”¹
Let’s be clear… not all physicians approach their patients this way, nor is it intended by most. However, patients only know how they feel after these seemingly dismissive encounters, feeling unheard and leaving with unanswered questions.
How Patients View Medical Gaslighting
Patient guests on the podcast describe medical gaslighting in many ways. There are a few common behaviors they have suffered during their provider interactions:
- Dismissing or downplaying symptoms; “blowing” off symptoms
- Failing to engage in conversation
- Attributing symptoms to stress, menopause, obesity, or the menstrual cycle
- Insisting symptoms are psychosomatic
- Telling patients there are no other options
A 2022 University of Illinois study by Communication Professor Charee Thompson and graduate student Sara Babu found that women with chronic health issues like endometriosis, Crohn’s disease, MS, or anxiety often left medical visits feeling unheard. The emotional toll led many to doubt themselves, worsening both their physical and mental health.
The study found “The women’s experiences reflect a form of implicit bias, discrimination and disempowerment that women have faced for centuries.”²
Being told “your tests are normal” when symptoms persist and no other options are made available or suggested can be defeating and deflating for patients, leading to nothing but the “revolving door” of healthcare. One podcast guest was told after seeing multiple physicians that her symptoms were psychological (and documented as such in the chart), only to later be diagnosed with POTS (Postural Orthostatic Tachycardia Syndrome). Even after her diagnosis, she is still traveling hours for care that may not fully address her condition. Her story, first shared in 2023, highlights how long patients can suffer without proper validation or treatment, if not longer.
Another guest experienced vague, escalating symptoms and was repeatedly told, “You’re just getting older” or “It’s stress.” After seeing five specialists and waiting eight months to get into a lupus clinic, she finally received diagnoses of lupus and Sjogren’s syndrome.
“I felt like if I hadn’t been an advocate for myself, I’d still be back where I started feeling terrible and not knowing why.”
Silence Has a Cost But Listening Builds Loyalty
Patients who feel dismissed do not disappear quietly. They talk to friends. They leave reviews. They share their stories. These stories spread and influence how others choose their care.
Healthcare organizations spend millions on technology and marketing, but retaining patients may depend on something far simpler: whether people feel seen and heard.
Dismissiveness is not just a matter of hurt feelings. It delays diagnoses, increases the cost of care for both patient and the system, reduces the likelihood of treatment adherence, Other times these alternative therapies are bogus and those “providers” are merely taking advantage of patients’ desperation for treatment or at least relief.
In a competitive healthcare market, keeping patients is not only about patient satisfaction scores, clinical quality, revenue, or reputation. It is also about the emotional experience. Patients who receive compassionate care often describe it as life-changing.
“He really listened. It wasn’t just about the symptoms, but how I felt about everything happening to me.”
Compassionate care should be the norm, not a pleasant but shocking surprise. For a health system CFO, compassion is more than kindness and a potentially healing relationship. It is strategic.
Redefining Healing and the Role of Empathy
One physician guest explained medical gaslighting is often rooted in systemic issues. These include time pressure, implicit bias, and an overreliance on objective data. It is not always personal, but the damage to patients is very real. Speaking from one physician’s point of view, “If someone comes in and you don't take what they're saying seriously, then that’s the first strike. And for many people, it’s the last.”
She added: “There are disparities in how people are treated. There’s this underlying belief in some corners of medicine that certain people exaggerate symptoms. And that’s incredibly dangerous.”
From this physician’s perspective, real listening could transform care: “If we really listened the first time, we’d avoid so much harm, misdiagnosis, and unnecessary cost…We’ve been trained to be so focused on the body part, the lab, the scan — but we forget there’s a person attached to all of that.”
Health systems are not losing loyalty (or not gaining it I the first place) because of clinical outcomes alone. They are losing patients due to emotional neglect. While clinicians face burnout, technological demands, and time constraints, patients are not aware of those pressures. They only experience rushed and disconnected interactions.
A young Gen Z patient guest suffered for years with severe pain and frequent joint dislocations. Her symptoms were dismissed as psychological until she was finally diagnosed with Ehlers-Danlos Syndrome (EDS). Describing an Emergency Department encounter, she explained, “I’ve been in the hospital screaming in pain, and a nurse told me, ‘You’re being too loud — we’re trying to send you home.’ An hour later, I was in emergency surgery.”
To win patients back, healthcare leaders need to place value on connection as much as they do on efficiency. That includes:
- Training clinicians in active listening and empathic communication
- Revising metrics to include the quality of interaction, not just speed and number of patients seen (and ultimately lost) in a day
- Validating patients’ feelings and acknowledging their frustration and suffering, especially when the diagnosis is unclear
- Collecting feedback about emotional experience, not just clinical results
“Dr. Google” Is Not the Enemy
Part of the medical gaslighting scenario patients describe is that clinicians often react with frustration when patients bring internet research into the exam room. But most patients do this not to challenge the doctor, but because they feel desperate to find answers and consider doing so as self-advocacy.
Rather than push back, providers can reframe their thinking and and respond differently:
- “Tell me what you found.”
- “Let’s walk through that together.”
- “Here are some reliable resources.”
This creates trust and shows patients they are being taken seriously.
The Bottomline
Health systems, and their clinicians, do not lose patients because they cannot find a diagnosis quickly enough. They lose them when patients feel they are treated as if they are not worth diagnosing at all. Patients are not expecting perfection. They are asking for compassion, understanding, and a caring partnership.
My advice to patients… never give up and keep pushing for answers!
Contact Laura at: [email protected] or LinkedIn Profile.
References:
- Quote from Medical Gaslighting: A Clinician’s Guide to Improving Patient Experience and Diagnostic Accuracy. Isaac KS Ng, MBBS, MRCP (UK)a,b∙ Sarah ZL Tham, MBBSc ∙ Gaurav Deep Singh, MBBS, MRCP (UK)a,b ∙ Christopher Thong, MBBS, MRCP (UK)b,d ∙ Desmond B. Teo, MBBS, MRCP (UK)b,e,f [email protected], . (October 2024) “Medical Gaslighting: A New Colloquialism.” The American Journal of Medicine, Volume 137, Issue 10, p920-922, https://www.amjmed.com/article/S0002-9343(24)00396-6/fulltext
- University of Illinois study by Charee Thompson and Sara Babu, 2022., https://news.illinois.edu/implicit-bias-prevents-women-from-obtaining-prompt-treatment-for-health-problems/