Why the 'Word of the Year' Has a New Meaning in Medicine

Gaslighting. A term that has increased in popularity in recent years, so much so that it has emerged as Merriam-Webster’s 2022 Word of the Year. In 2022 alone, the dictionary publisher noted it saw a 1740% increase in searches for gaslighting, with high interest consistent throughout the year. This designated “word for our time” has spilled over into the field of medicine, described by The New York Times as medical gaslighting, or the experience of having one’s concerns dismissed by a medical provider.

As a physician, I find accounts of patients feeling unheard or dismissed by their clinicians deeply troubling. Studies have shown that medical gaslighting has disproportionately affected women, people of color, geriatric patients, and LGBTQ+ patients.[1],[2],[3] In healthcare, the ability to earn and give trust is an important human act. It requires individuals to put their welfare in the hands of another and have confidence that their vulnerability will be reciprocated with something important to them. Trust between patients and their physicians is an established keystone of care—something that can be actively nurtured and easily lost.

In the era of ubiquitous pharmaceutical ads, health food stores, and self-interested bloggers selling their versions of the truth, it’s not uncommon for patients to come to my office with preconceived notions or skepticism about the medicines I prescribe, and treatment plans I recommend. I appreciate those that feel empowered to research their condition and come prepared with questions, and it’s my duty as a physician to listen to my patients and make them feel understood. Practicing medicine is not just about clinical skills, but also honing interpersonal skills to support a positive therapeutic relationship.

Continuing medical education (CME) has traditionally been perceived as training for physicians related to clinical knowledge and technical skills. And while this is true, the scope of accredited CME extends well beyond clinical care. Physicians rely on accredited CME to address every medical specialty and cover the full range of topics important to healthcare improvement, such as training on implicit biases, communication skills, and strategies for patient-centric care. Physicians looking for accredited education can visit www.cmepassport.org, a new web application by the Accreditation Council for Continuing Medical Education (ACCME), and search for accredited activities by specialty or keyword—such as “trust” or “communication”—that meets their educational needs. Further, stakeholders across the medical education continuum have established a set of core competencies to help define the foundational skills every practicing physician should possess—and interpersonal and communication skills are aptly included on this list.

In my practice, I’ve found it useful to have my patients repeat back to me what they’ve heard after I’ve explained a treatment plan or introduced a new medication. This process helps me understand what my patients are absorbing when I’m speaking, and also helps me identify any gaps in my communication so I can improve for the next appointment. I’ve found that identifying and addressing these gaps is especially important during telehealth appointments where the level of patient engagement tends to decrease. In addition, I offer written summaries of our plan and allow time for patients and/or their loved ones to ask me questions or share their concerns—what’s important to my patients is important to me.

It is clear that many people have felt ignored, mistreated, or dismissed during times when they needed compassionate, quality care. Fortunately, accredited CME can serve as a vital tool for addressing existing barriers and offer key training on how to deliver effective care when patients need it most. After 20 years in medicine, I’m optimistic that our profession can continue to move toward a place of empathy and understanding. Come the close of 2023, I hope the Word of the Year is kindness.

#cme #medicaleducation #gaslighting #wordoftheyear #patientcare

[1] “Women Are Calling Out ‘Medical Gaslighting’.” The New York Times. Accessed December 1, 2022. https://www.nytimes.com/2022/03/28/well/live/gaslighting-doctors-patients-health.html.

[2] “Feeling Dismissed? How to Spot ‘Medical Gaslighting’ and What To Do About It.” The New York Times. Accessed December 1, 2022. https://www.nytimes.com/2022/07/29/well/mind/medical-gaslighting.html. 

[3] “Doctors and Racial Bias: Still a Long Way to Go.” The New York Times. Accessed December 1, 2022. https://www.nytimes.com/2019/02/25/upshot/doctors-and-racial-bias-still-a-long-way-to-go.html.