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Angharad Hughes, partner and joint head of clinical negligence at JMW, looks at the hidden cost of medical gaslighting.
The term “medical gaslighting” has become increasingly common in discussions about patient safety and healthcare standards. While it is not a formal medical diagnosis, it is often used to describe situations where patients feel their symptoms have been dismissed, minimised or attributed to non-physical causes without appropriate investigation.
Recent figures suggest that 70% of women and 52% of men report this experience, often on more than one occasion. Medical gaslighting, however, is rarely the result of a single consultation. More often, it develops over time through repeated experiences where concerns are not fully explored, symptoms continue to worsen, and opportunities for diagnosis are missed.
It is also important to distinguish medical gaslighting from genuine diagnostic uncertainty. Many medical conditions present with non-specific symptoms that can be difficult to diagnose. Healthcare professionals are often required to make complex clinical decisions based on limited information. The concern arises when symptoms are repeatedly dismissed without appropriate assessment, monitoring or referral.
It is undeniable that most medical professionals are motivated to assist and support patients, and do so. Clear communication and patients advocating for themselves can help ensure concerns are discussed and addressed. However, where repeated dismissal leads to avoidable harm, there may be grounds to consider a clinical negligence claim.
What is medical gaslighting?
Medical gaslighting occurs when a patient’s symptoms are dismissed, minimised or attributed to psychological or lifestyle factors without adequate clinical assessment. These factors can have a significant impact on the patient’s medical presentation and a wide range of conditions, the key point is that these are discussed and considered by the medical professional. When symptoms are repeatedly attributed to stress, anxiety or lifestyle factors without adequate investigation, patients may experience substantial delays before receiving the treatment they need.
One of the difficulties in identifying medical gaslighting is that patients are frequently reassured while investigations are ongoing or where symptoms are expected to improve naturally. The concern arises when reassurance replaces investigation despite symptoms persisting, worsening or presenting with potential warning signs.
Common warning signs include repeated reassurance that symptoms will resolve without appropriate investigation; attributing symptoms to anxiety or stress without a thorough physical examination; and a failure to refer a patient for specialist assessment despite persistent or worsening concerns.
These experiences have measurable consequences. Research examining over 14,000 cancer patients found that 24% reported an avoidable delay in diagnosis where early symptoms were overlooked. In cases of endometriosis, the average time to diagnosis in England is eight years and 10 months and nine years and 11 months in Wales, a figure that has continued to worsen. Where earlier investigation would have identified a condition and altered the clinical outcome, the consequences of delay can be serious and lasting.
Who is most affected?
Medical gaslighting can affect anyone, but evidence suggests that some groups experience symptom dismissal more frequently than others. Much of the recent discussion has focused on women’s health, with 28% more women reporting that their concerns have been dismissed by a healthcare professional than men. This has been described as medical misogyny, with reproductive health conditions frequently normalised or under-investigated by the Women and Equalities Committee in Parliament.
Certain types of symptoms are also more frequently subject to dismissal. Chronic pain conditions, fatigue-related illnesses, neurological symptoms and some mental health presentations can be more difficult to diagnose because they do not always produce clear diagnostic test results. This can increase the risk of symptoms being attributed to less serious causes before appropriate investigations have been completed. It may be that a chronic condition is not the correct diagnosis, but the key point is that concerns are investigated and the patient is kept fully informed.
There are also wider pressures within the healthcare system that may contribute to these experiences. Increasing demand on NHS services, limited consultation times and pressure on diagnostic pathways can all make it more challenging for clinicians to explore complex presentations fully. Recognising these pressures does not excuse poor care, but it helps explain some of the factors that may contribute to delayed diagnosis.
The impact of dismissal
The consequences of medical dismissal are not limited to the progression of an underlying condition.
Patients who feel repeatedly dismissed often describe losing confidence in their own judgement and becoming reluctant to seek further medical advice. This can create a cycle in which worsening symptoms go unreported because previous attempts to obtain help were unsuccessful. For some people, the psychological effects can be substantial. Living with ongoing symptoms while feeling unheard can contribute to anxiety, frustration and loss of trust in healthcare services. Where diagnosis is eventually achieved, patients may look back and recognise that opportunities for earlier intervention were missed.
In some cases, delays can lead to a worsening prognosis, more invasive treatment requirements or avoidable complications that may have been prevented through earlier investigation.
Not every delayed diagnosis or communication failure amounts to clinical negligence.
The law recognises that healthcare professionals are often required to make difficult decisions based on the information available at the time. A poor outcome alone does not mean negligent treatment has occurred.
Clinical negligence may arise where a healthcare professional fails to provide treatment that meets the standard expected of a reasonably competent practitioner, and that failure causes avoidable harm. Examples may include failing to investigate persistent symptoms appropriately; failing to refer a patient for specialist assessment when indicated; reaching a diagnosis prematurely without considering alternative explanations; and failing to act on evidence that a patient’s condition is deteriorating.
In these situations, the key legal question is often whether earlier investigation, referral or treatment would have changed the patient’s outcome. Establishing this usually requires a detailed review of the medical records and independent expert evidence.
The importance of listening in clinical assessment
Effective healthcare relies on collaboration between patients and healthcare professionals. Patients provide information that cannot be obtained through tests alone, including changes in symptoms, pain levels and the impact a condition is having on daily life.
Many serious conditions are identified because patients recognise that something has changed and continue seeking help when symptoms persist. Listening to those concerns forms part of effective clinical assessment and decision-making.
Patients should feel able to ask questions, seek clarification and request further advice if symptoms continue or worsen. Seeking a second opinion can also be appropriate where concerns remain unresolved, and there is guidance available for this process.
Medical gaslighting is often discussed as a communication issue, but its consequences can be much more serious. When symptoms are repeatedly dismissed or insufficiently investigated, opportunities for diagnosis and treatment may be missed.
While not every delay in diagnosis will amount to negligence, there are circumstances where a failure to listen, investigate or refer can lead to avoidable harm. Understanding the difference between diagnostic uncertainty and negligent care is an important part of improving patient outcomes and maintaining trust in healthcare services.
Where concerns about symptom dismissal have resulted in a delayed diagnosis or worsening condition, it may be appropriate to seek legal advice about what happened and whether the standard of care provided was reasonable.
