Takeaway
Actively listen to and validate patients' experiences, recognizing their unique knowledge of themselves. Providing thoughtful support can earn patients' trust and help them feel better about their circumstances.
Connecting with Patients | May 1, 2025 | 2 min read
By Andrew Gill, PhD, Johns Hopkins Medicine
“Medical gaslighting” refers to the invalidation of a patient’s experience by their health provider. This can take many forms but often has similar results: delayed or faulty diagnosis, dissatisfaction and disengagement by both parties, and worse health outcomes. We’re all vulnerable to gaslighting, usually unintentionally, when confronted with problems that don’t easily fit within our existing mental frameworks.
Here are strategies to help us avoid this trap:
1. Check your ego.
Unfortunately, the risk for clinician arrogance goes up as expertise and specialization increases. Keep in mind that no one can know everything and that every patient knows a lot about themselves that we don’t.
2. Ask questions about the person in front of you, not just their disease.
How have their symptoms affected their quality of life? Why did they make this appointment at this time? What are they afraid of or would like to know? Such questions promote a human connection and reduce the power imbalance between patient and healthcare professional.
3. Welcome data provided by the patient.
See it as desire to be taken seriously, not as a sign of anxious preoccupation. Many people with chronic health conditions have learned that they won’t be believed if they don’t keep a record of their symptoms. Working out a means for them to share new data with you before follow-ups (e.g., via electronic health message) can save time during appointments and centers their concerns within your conversations.
4. Remember that the mind-body connection is bidirectional.
Stress, anxiety, low mood, and difficulty coping are natural responses to health problems. Although co-occurring mental health conditions should be sensitively addressed, be explicit that you’re not suggesting that they’re the cause of the patient’s condition. Also, keep in mind that just because a condition improves with psychiatric or psychological treatment doesn’t mean it’s psychosomatic.
5. Explain your process and plan.
If you’re requesting labs or tests, explain what they’re for and what to expect. Also explain what you’re not ordering and why.
6. It’s ok to not have a definitive answer and it’s ok to say, “I don’t know.”
This may be the most validating thing you can do, as you’re joining the patient in their uncertainty and concern.
7. Even when you can’t solve the medical problem, you can still help.
Consult the literature and share new research with patients. Refer them to a specialist if warranted. Clarify what you’re able to offer, even within your limited scope. Such acts demonstrate that, even if you can’t cure, you’re not dismissing them.
8. Be honest with yourself about your implicit biases.
We all have them, and it’s your awareness of them that will allow you to act differently. After you acknowledge your brain’s automatic response to a patient, ask whether it will help them. When you want to find a more helpful response, consider how you would want a loved one’s clinician to address them in the same moment.
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This piece expresses the views solely of the author. It does not represent the views of any organization, including Johns Hopkins Medicine.