Physician gaslighting: “are we all toxic & excluded?”

How the idea of gaslighting applies to discrimination in healthcare professions

Written and edited by Nida Fatima, MD and Jakob Bower.

The thriller play entitled Gas Light, based on themes of emotional abuse and manipulation, premiered in London in 1932 and was adapted into an American film by the same name in 1944.

This story brings to light a patriarchal system where men dominate over women by diminishing their dignity with false psychological claims, labeling them as frantic and hysterical. It provides a message which applies to many current social issues, such as making discriminatory assumptions, spreading misleading messages, and doubting one’s own sanity.

Gaslighting may be experienced by any individual for a variety of reasons, but here we will discuss evidence that applies to female physicians and gender issues.

There are existing definitions of medical gaslighting which refer to physicians dismissing women’s health problems, enforcing the misogynist stereotype that women are irrational and “hysterical.”

However, there is much more than that. Toxic power dynamics in medicine impact professionals as well; gaslighting is ingrained in healthcare power structures.

There is not a single week when we don’t hear a successful female physician stating, “I am thinking of leaving my job in medicine.” Women physicians are offered lower starting salaries in 93% of 45 different subspecialities, and 96% of subspecialties will pay them less over ten years—even with the same training as male counterparts in the same specialty.

Gaslighting by patients themselves is another issue. Patients often consider female surgeons less competent. There have been several reports where patients are diagnosed and scheduled for surgery by a female physician but prefer to be operated on by a male physician. Despite excellent bedside skills and surgical skills, societal norms put immense pressure on female physicians.

In terms of family needs, female full-time physicians spend more time on parenting and household work versus male physicians. The COVID-19 pandemic has contributed to further domestic inequality regarding parenting needs and increased responsibilities for women.

The degree to which these issues—societal pressures, gender inequalities, family needs—affect women more than men should make us reconsider the systems of bias and discrimination that are at their roots.

There is a dire need to stop gaslighting based on any sort of assumption. We should remind ourselves that no one is superior to the other in terms of race, gender, or creed.

We must foster a way of living and working where everyone has equity in their rights and everyone can contribute. Let’s be transparent regarding compensation, time, power, and career trajectory, and let’s hold those in power accountable for the fairness of the systems they represent.

Raise your voice and spread awareness so that future generations don’t have to deal with the same problems.

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