ECRI just published in its Top 10 Patient Safety Concerns 2025 that the risks of dismissing patient, family, and caregiver concerns is now the number one safety concern. The term refers to instances where patients feel their symptoms are dismissed, minimized, or outright ignored by clinicians. Intentionality is not always present: Most occurrences are rooted in systemic issues such as time constraints, communication breakdowns, cognitive biases, and overwhelming administrative burdens. This article is a balanced perspective on medical gaslighting from both patient and physician viewpoints. Contributing factors and concrete recommendations are made.

The patient’s perspective: Feeling dismissed

Patients often describe medical gaslighting as being dismissed, invalidated, or patronized by their health care providers. Women, minorities, the elderly, and individuals with chronic conditions are particularly vulnerable to this experience. Studies indicate that women are more likely than men to have their symptoms attributed to psychological causes rather than physical ones. In one survey, 71 percent of women reported being told their symptoms were “imagined” or stress related.

Implicit bias also plays a significant role in patient experiences of dismissal. Black patients, for example, are less likely to receive pain medication compared to white patients presenting with identical complaints. Misdiagnosis rates further highlight the problem. According to the Agency for Healthcare Research and Quality (AHRQ), approximately 12 million Americans are misdiagnosed every year, contributing to 10 percent of patient deaths and 6–17 percent of adverse hospital events.

Medical gaslighting is not limited to overt dismissal. Often, patients describe feeling unheard during brief, rushed appointments. A study from the 1980s found that physicians interrupt patients within 18 seconds of starting their opening statement. A more recent study observed a median interruption time of only 11 seconds. Interruptions can prevent patients from fully conveying their symptoms, with diagnostic errors and inadequate treatment plans as a result.

In addition to ECRI’s findings regarding dismissals of patients’ concerns, they warned that rushed visits, communication breakdowns, and clinician biases are creating an environment ripe for medical gaslighting. Patients who feel dismissed often delay seeking further care, lose faith in the health care system, or develop heightened anxiety about their health.

The physician’s perspective: systemic pressure and burnout

On the flip side, most physicians do not intend to dismiss or undermine their patients’ concerns. However, systemic pressures such as limited appointment times, administrative burdens, and the overuse of Electronic Health Records (EHRs) contribute significantly to communication failures.

A study conducted by the American Medical Association and Dartmouth-Hitchcock Health System found that physicians spend nearly 49 percent of their workday on EHR-related tasks and only 27 percent on direct patient care. Digital documentation has improved record-keeping and continuity of care but has also introduced new challenges. For every hour of direct clinical time, doctors spend nearly two additional hours on EHR and desk work.

Burnout is another contributing factor. According to the American Medical Association, over 40 percent of physicians experience symptoms of burnout, which include emotional exhaustion, depersonalization, and reduced empathy. Burnout diminishes attentiveness, impairs decision-making, and exacerbates cognitive biases that may lead to dismissive interactions.

Time constraints compound the problem. In many primary care settings, appointments are scheduled in 15-minute blocks, forcing physicians to prioritize efficiency over thoroughness. Studies have shown that when doctors feel rushed, they are more likely to interrupt patients, make diagnostic errors, or revert to cognitive shortcuts that may not accurately reflect the patient’s condition.

The label “gaslighting” can feel accusatory to clinicians who are striving to provide the best care possible under challenging conditions. Many physicians experience what has been termed moral injury—the emotional burden of being unable to deliver the quality of care they believe their patients deserve. This disconnect between intention and perception often leads to frustration on both sides.

Bridging the gap: communication and systemic reform

Poor communication remains a critical factor in adverse health care outcomes. A comprehensive review of 23,000 malpractice claims revealed that communication failures contributed to over 7,000 cases, resulting in $1.7 billion in costs and nearly 2,000 preventable deaths. Additionally, The Joint Commission reports that 80 percent of serious medical errors involve miscommunication during transitions of care.

Effective communication is not only about listening but also about validating patient experiences, explaining diagnostic reasoning, and establishing clear follow-up plans. Studies have demonstrated that active listening, empathy, and shared decision-making correlate with improved patient adherence, satisfaction, and outcomes.

10 tips for patients and providers

For patients:
Prepare concise notes on symptoms and concerns.
Prioritize issues to address within the appointment time.
Be specific and descriptive about symptoms.
Use “I” statements to express concerns.
Ask for clarification if explanations are unclear.
Follow up if symptoms persist or worsen.
Maintain personal medical records for accuracy.
Bring a trusted advocate if feeling anxious or dismissed.
Express gratitude for attentive care.
Seek second opinions when necessary.

For providers:
Allow patients to finish their opening statements.
Validate patient experiences, even when symptoms are unclear.
Avoid dismissive language such as “It’s just stress.”
Explain diagnostic reasoning transparently.
Create structured follow-up plans and communicate them.
Reflect on implicit biases and challenge assumptions.
Balance efficiency with empathy during interactions.
Seek feedback to improve communication skills.
Prioritize wellness to prevent burnout.
Advocate for systemic changes that enhance patient-centered care.

Conclusion

Medical gaslighting is a complex issue involving both systemic factors and individual interactions. Improving communication between patients and providers is essential to restore trust and enhance diagnostic accuracy, resulting in optimal clinical outcomes. By acknowledging patient experiences and addressing systemic pressures faced by clinicians, we can bridge the gap between “being heard” and “being helped.”

Alan P. Feren is an otolaryngologist.