In healthcare, the term 'gaslighting' has gained traction, describing a troubling dynamic where patients' symptoms are dismissed or minimized by medical professionals. This phenomenon is especially prevalent among women, people of color, and older adults, often leading to feelings of confusion and frustration. For those struggling with undiagnosed or rare medical conditions, such dismissive encounters can be devastating.
Perspectives on gaslighting by renowned neurologist and headache specialist, Dr. Alan Rapoport, sheds light on the complexities of medical gaslighting. "I don't use the term and I don't usually hear the term gaslighting of patients, but I would say what would fall into that category would be if a patient leaves the office, and they're unhappy about the history that the doctor thinks he heard when he took the history. Or the diagnosis that the doctor made, which runs counter to what the patient thinks is wrong," Dr. Rapoport explains. He acknowledges that the current medical landscape often places physicians in difficult positions. With constrained time and immense pressure, doctors sometimes unintentionally dismiss patients' symptoms. "It's more difficult to practice medicine today than it was when I started out 52 years ago," he notes. The increased workload and limited time exacerbate the situation, making it challenging for doctors to provide comprehensive care.
Dr. Rapoport emphasizes the importance of validating patients' experiences, regardless of whether their symptoms fit neatly into a specific diagnosis. "If a patient leaves unhappy, it probably has something to do with the doctor looking and feeling like they don't have enough time for the patient because that's kind of true," he explains. Addressing this requires a concerted effort to build patient trust and take their concerns seriously. One approach to combating medical gaslighting is involving patients in their care decisions. Dr. Rapoport advocates for a collaborative approach, stating, "The good doctors, in my opinion, will say, look, I hear what your history is. I've examined you. And my feeling is you could have one of these three things, and it could even be something else. I want to do some testing... and you and I are going to discuss this together." This participatory method can significantly reduce patient anxiety and foster a sense of agency.
Dr. Rapoport recalls a poignant case: a patient who was placed in a psychiatric ward for insisting she was dying. Upon his detailed examination, it was discovered that she had a hidden cancer causing significant health issues. This case underscores the importance of thorough investigations and the potential harms of dismissive judgments.
Medical gaslighting is a serious issue that demands attention. By fostering open communication, validating patient concerns, and incorporating collaborative decision-making, healthcare providers can mitigate its impact. As Dr. Rapoport suggests, "Your health is very important to you, even if you think your health isn't being taken care of you should still switch [doctors]." While medical gaslighting is a complex problem influenced by systemic constraints, enhancing patient-doctor communication and adopting a more empathetic approach can pave the way for more effective and respectful healthcare experiences.
To hear the entire episode, EP 28: Navigating Medical Gaslighting and Modern Diagnosis with Neurologist and Headache Specialist, Dr. Alan Rapoport, listen on your favorite app, on YouTube or here on the website.
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