Medical Gaslighting

[somarco]

An annual ranking of the top 10 patient safety concerns, released Monday by the healthcare quality and safety group and its Institute for Safe Medication Practices (ISMP) affiliate, places dismissed concerns above other issues like insufficient artificial intelligence governance and medical misinformation.


Specifically, it points to a 2023 survey in which 94% of respondents reported instances in which they felt their symptoms were being ignored or dismissed by a doctor—leading to an experience the group referred to as "medical gaslighting," in reference to when an individual is manipulated in questioning their perceptions.

'Medical gaslighting' tops patient safety concerns for 2025, ECRI warns

Clinicians’ increased burdens are making it harder for valid concerns voiced by patients, their families and their caretakers to be acknowledged, raising the risk of missed diagnoses and exacerbate | An annual list of the 10 biggest threats to patient safety highlights the risk of doctors...

www.fiercehealthcare.com

 

[scagnt83]

This happens a lot in our "turn and burn" type of care system.

My grandmother complained of pain for 15 months before the doctor took her seriously. She was diagnosed with ovarian cancer once taken seriously.

Older folks are also more likely to just accept what the doctor tells them vs. seeking a second opinion, or pushing back on being dismissed.

 

[LeeV]

94% of respondents reported that they were being ignored or dismissed by their doctor. That seems a little high. Now if you told me that 94% of wives said their husbands ignored/dismissed them, that I would believe. LOL

 

[somarco]

94% of respondents reported that they were being ignored or dismissed by their doctor.

Close, but no cigar.

The report says the FELT they were being ignored. Not the same.

I am not attacking them or defending the provider, just saying emotion is not the same as fact.

OTOH, how many times are providers WITHHOLDING or soft pedaling something about the diagnosis?

Flip side, doc says you have X medical problem, something to be aware of and you need to get this checked. But the patient dismisses it as something minor and goes on about their business.

I can't say how many times someone says they are in good health but then are on 4 different BP meds. When I counter with, so you have HBP . . . NO, I don't have HBP because I take medication . . .

 

[annon123]

My grandmother complained of pain for 15 months before the doctor took her seriously. She was diagnosed with ovarian cancer once taken seriously.

The symptoms of my follicular non-hodgkin's lymphoma were ignored, explained by benign reasons, etc, for nearly 8 years until someone took them seriously. Good thing that cancer is indolent but the lifespan of untreated fnhl is about 8 years. I got very lucky someone finally took my issues seriously. I live in a state though where health care is really crappy.

 

[sman]

The symptoms of my follicular non-hodgkin's lymphoma were ignored, explained by benign reasons, etc, for nearly 8 years until someone took them seriously. Good thing that cancer is indolent but the lifespan of untreated fnhl is about 8 years. I got very lucky someone finally took my issues seriously. I live in a state though where health care is really crappy.

Symptoms for 8 years and they were simply explained away without looking further? Holy crap! That's malpractice.

Glad to hear someone finally took it serious.

 

[sman]

Flip side, doc says you have X medical problem, something to be aware of and you need to get this checked. But the patient dismisses it as something minor and goes on about their business.

We had a similar issue where the PA, due to slightly abnormal labs along with some symptoms, told my wife she could have one of a few things and wanted her to see a few specialists to either rule out or diagnose her. These were serious conditions she told my wife she could have.

So of course the fear sets in and we schedule appointments first with a Rheumatologist who did some seriously expensive lab work that wasn't covered. On the follow up she said "I have no idea what is causing your symptoms". And that was it.

Went to a Hematologist who, when he entered the room, demanded that we put masks on. This was well on the back end of covid when things were pretty much back to normal. His solution, because her iron was at the low end of normal, was expensive iron infusions. Screw that.

Then we had to see a neurologist. He was super helpful in explaining the lab result that the PA overreacted to that sent us to him. Her numbers were slightly elevated and something as simple as light exercise before having labs done could cause that. Hers were in the 300's. The people who have the issues the PA was concerned about are in the 3,000-4,000 range. The neurologist asked when the symptoms began (5 months prior) and then asked what happened 6 months prior. My wife's mom died. He went on to explain how are brains work after trauma. He felt that was the issue and tried to give a prescription (Xanax). No thanks.

At that point we decided my wife needed a different PCP. We found a concierge doctor for her. First visit, my wife shared all that she had been through regarding these visits. The doc told her one of the side effects of the medicine she was taking for hot flashes could quite possibly be the reason for her symptoms. Sure enough, she stopped taking it and the symptoms went away. Several thousands in doctor visits and tests only to find out all of it was because of a medication.

This is why they call it practicing medicine. Sometimes they don't have a clue. I would encourage everyone to be your own advocate. Do research. Ask questions. Push back if you have to.

 

[somarco]

@sman I'll bet you can't wait until the providers are using AI to diagnose . . .

 

[sman]

@sman I'll bet you can't wait until the providers are using AI to diagnose . . .

I'll trust it as much as I do doctors. Although I've read anecdotal stuff where people have uploaded their MRI's to Grok and gotten the same diagnosis as the person who reads the MRI and gives their assessment.

 

[annon123]

I'll trust it as much as I do doctors. Although I've read anecdotal stuff where people have uploaded their MRI's to Grok and gotten the same diagnosis as the person who reads the MRI and gives their assessment.

From research I have read AI is good at routine issues and clear cut diagnosis. It is not good at dealing with complicated cases.

The use of AI to write visit notes (something the Cleveland Clinic is thinking of doing) concerns me as I doubt some medical providers will spend the time to read it carefully or correct the mistakes in it. There are already enough mistakes in electronic medical records. Doing this will only make it worse. Yes medical professionals need a way to cut down on the time it takes to do this kind of stuff but I don't think this is the way to do as there will be no way or little way for systems to tell if the person corrected them or just hit submit. Yes keystroke tracking or timing how long they are in it will do that but I'd think professionals would scream about keystroke tracking and time the file is open as the proxy measure is easy to defeat.

Already there is a problem with your medical team answering messages with "we will send this on to the team (when they are the team) or uploading patient instructions instead of visit notes and then taking ages to upload visit notes. Satisfies the bean counters and defeats the purpose of the rules.