Medical gaslighting: Are you doing this to your patients and other doctors?
Key Takeaways
Gaslighting refers to when someone in a position of power uses manipulative tactics to make another person question their sanity. It can occur among physician colleagues or between doctors and patients.
In medicine, gaslighting can be described as an understated form of bullying that frequently is perpetrated by male physicians on their female counterparts. Female patients also may experience it.
Ways to avoid gaslighting include treating patients with integrated-care teams, trying gender-based approaches to disease management, and having patients seek second opinions or be referred to specialists.
Do you know where the term gaslighting came from? In the 1944 classic film Gaslight, set in 1880 London, Ingrid Bergman plays the role of a wife who is left questioning her own sanity after her husband continually manipulates her with stealthy torments. For instance, he dims the gas-fueled lights in the house and denies doing so, which makes his wife doubt her perceptions about reality.
Gaslighting refers to when someone in a position of power uses manipulative tactics to make another person question their sanity. The term cropped up in the 1960s and has been demonstrated in a variety of fields and contexts.
According to experts, gaslighting can be worse than physical abuse.
You may wonder whether gaslighting is present in the medical field. It sure is. Gaslighting can occur among physician colleagues or between doctors and patients. Here’s a closer look.
Gaslighting colleagues
In a 2021 article published in Canadian Family Physician, the author Sarah Fraser, MD, detailed her own experiences with gaslighting, which reflect her position as a female primary care physician dealing with male specialists.[] She also described the nature of gaslighting in medicine, which she terms medlighting.
Unlike other forms of medical bullying, medical gaslighting does not entail blatant threats/insults or public humiliation.
Instead, it is more understated and covert. It is hidden and erodes self-esteem and mental health of attendings, residents, and medical students. Unlike the frank delusions and distortions of memory or violence evident in extreme forms, gaslighting in medicine is more insidious. The author of the aforementioned article wonders whether gaslighting is why women in medicine do not pursue leadership positions.
"As a woman who is also a family physician, I have been gaslit multiple times by colleagues in professional settings."
— Sarah Fraser, MD
"As a generalist, when I interact with specialists, it is normally a positive and productive experience facilitated by mutual trust and respect," the author said. "This made it all the more shocking when my specialist colleagues have used their status as an expert to try to convince me of something I know to be false or not in the best interests of my patients.”
The author went on to discuss how when she was working as a hospitalist, she received concerning diagnostic results about a patient. She called the specialist who then gaslighted her by minimizing her concerns; he complained that she was bothering him with a “nonurgent” issue. The interaction resulted in the author questioning her own judgment in calling the specialist. Later when visiting the patient, he questioned how long she had been out of residency, thus establishing a pecking order. This power play further facilitated the gaslighting.
The author opined that women are particularly susceptible to gaslighting. On the other hand, women often can’t typically gaslight men because they lack the economic, cultural, and social means—with patriarchal power structures the norm. She stressed that younger, racialized, non-specialist women are at greatest risk for gaslighting by colleagues. Inequalities render women who are the victims of medical gaslighting unable to accuse perpetrators or redress themselves from undue rebuke.
Gaslighting patients
Another form of medical gaslighting is when a healthcare practitioner dismisses a patient's complaints or concerns, which can lead to missed diagnoses and serious health consequences. According to the authors of an article posted on Northwell Health that draws on input from various physician experts, gaslighting is especially an issue with female patients, too.[]
“There’s still this pervasive belief in the medical community that anytime a woman complains about her health, it’s either related to her hormones or all in her head,” stated one expert. “Female hysteria was once a common medical diagnosis for women, applied whenever women displayed ‘inappropriate’ emotions such as anxiety, anger, and even sexual desire. For centuries, it was believed that the uterus itself was the cause of a woman’s ‘hysterical’ symptoms.”
Examples of gender-biased gaslighting in women include attributing heart disease to anxiety or autoimmune disorders to depression.
Patients who feel they are being gaslighted, and who are not making progress with their provider, can seek out a second opinion, ask to be referred to a specialist, or visit a specialist center that employs a multidisciplinary approach. They can also contact a patient advocate or file a complaint.
What this means for you
"Medical gaslighting" is a form of bullying, in which a person of power uses manipulative tactics to make another person doubt their perception or sanity. It is frequently perpetrated by male physicians on their female counterparts or female patients. Recognizing the signs of medical gaslighting is the first step to addressing it. Clinicians should educate themselves on the concept of gaslighting in medicine, and refrain from making dismissive comments that result in a patient or colleague questioning their own perceptions or reality. Practitioners who feel they are being gaslit by a colleague should considering taking the matter to human resources to discuss options, as they would with other forms of bullying in the workplace.