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I’ve witnessed this second-hand with a family member and I’d say gaslighting is an adequate term for what happens to some patients.

Through some combination of weeks/months for a specialist availability, days to weeks for a primary care opening (with a group, not necessarily your specific doctor), and emergency rooms being at capacity, it’s seemingly impossible to get good care for chronic health problems.

ERs and urgent care facilities are not great options for chronic issues, but they’re often all that’s available. And because they aren’t the specialists and they have a narrow charter of work, they can’t really do anything aside from maybe steroids and morphine every once in a while. I do believe that these institutions are being brought down by the sheer volume of work presented to them and are trying to do their best to keep people alive… but it’s disheartening for everybody

I think I would agree. The behavior seems to be more dismissive than gaslighting (manipulative). I think a patient doubting their own knowledge or experience definitely happens, but it is a secondary effect from the dismissiveness from the medical provider and not usually the intention.

Unless, we consider it intentional so they need to do less work. Considering a person’s subjective information to be fully true and including that in the plan of care takes more effort, versus following the script you know.

This is part of a larger discussion that one of my classes is covering: “Traditional versus Collaborative Care.” Personally, I think the word collaborative gets tossed around too much and English needs more synonyms for it, but the theories kind of make sense. Traditional approach is basically “I’m the doctor, so I know what is best. If you don’t take these meds, you’re being non-compliant.” While the Collaborative approach is more like “What are the goals for your care?”

Some people don’t care what the provider thinks they care about, or aren’t communicating in a way that connects to the patient enough. A relevant podcast I listened to a while ago mentioned that most disagreements are caused by a difference in expectations. If the medical provider is expecting a “compliant” patient with no questions, they are going to be upset when someone is disagreeing with them. And if a patient is expecting a medical provider to listen to them, but the provider ignores them, they will probably be frustrated, belittled, etc.

The problem is the complete dismissal of subjective evidence as being a valid form of evidence. We have deified objective evidence to the point of hubris, denying the existence of anything that doesn't show up easily using our current technology. In my experience, it's less often gaslighting and more often an embarrassing lack of epistemological humility and a pretense that we are have somehow reached the pinnacle of medical technology already and have nothing left to learn.

We're here to treat patients, not test results. If a patient is reporting that they are experiencing distressing symptoms or that something is making them feel better or worse, they deserve to be taken at their word. Ignoring them because our current tests are not sophisticated enough to identify everything invalidates their subjective experience, and that's not patient centered care.

This is the real issue when people are talking about medical gaslighting. Every endometriosis patient being told for years on end that their debilitating symptoms are "normal" period pain. The embarrassing statistics on how long it takes someone with an autoimmune disease to be correctly diagnosed.

We've become too impressed with our technological toys and forgot how to see the real human beings in front of us.

AI will just end up being the worst habits of doctors because of arbitray insurance or other policy influences dismissing valid complaints and misunderstandings that the good doctors figure out how to identify over time.

Yes, some doctors are actually really good! AI won't ever do as good of a job as those doctors.

I don't know why you think an AI can do a doctor's job.....