‘Medical gaslighting’ emerges as leading threat to patient safety

Too many patients and family members are struggling to be heard by doctors and clinicians, and it’s emerging as a key problem in protecting patients.

In fact, ECRI named the dismissal of patient and family concerns as its top concern in the organization’s annual list of threats to patient safety. ECRI, a non-profit organization focused on patient safety, released its 2025 ranking of patient safety concerns Monday.

Too many patients are experiencing the equivalent of “medical gaslighting,” says Marcus Schabacker, MD, president and CEO of ECRI.

In an interview with Chief Healthcare Executive®, Schabacker says he doesn’t think doctors are intentionally engaging in “gaslighting,” the term used for deceiving or manipulating individuals into believing a false reality.

“We don't think there's a provider out there, a clinician out there, who goes to work and says, ‘Oh, I'm going to ignore patients’ concerns today,’” he says.

“We don't think that physicians are trying to mislead patients in a certain way,” Schabacker explains. “That's not what we're saying. But what we're saying is there's just not enough attention paid to what patients really say and what their symptoms really are.”

He also points out that 25 years have passed since the landmark report from the Institute of Medicine, “To Err is Human,” which found that 98,000 deaths due to medical errors occur in U.S. hospitals. And he says there’s still a great deal of work to do.

“We just haven’t made enough progress in patient safety,” Schabacker says. (See part of our conversation in this video. The story continues below.)

Schabacker says too many patients, families and caregivers are raising concerns to clinicians and physicians that aren’t being heard or are outright ignored.

Part of the problem is that physicians are carrying such high workloads and seeing so many patients that they aren’t listening as much as they should.

“We are so pressed for time that these basic things, these basic clinician skills of listening, just get lost,” he says.

As doctors face demanding schedules and are pushed to see as many patients as possible, they can also be susceptible to leaning heavily on a suspected diagnosis.

“It’s called confirmation bias, whereas you're just trying to confirm what you already think is happening,” Schabacker says.

Health systems and other providers must think beyond using technology to improve the organization, he says. Technology alone won’t improve a flawed process.

“So when we are just introducing new technology in an already stretched system where providers don't have a lot of time, providers are not allowed to appropriately interact with the patient, they're going to jump to conclusions,” he says.

Too often, Schabacker says women and members of minority groups don’t feel as if they’re heard by their clinicians. He says it’s a particularly difficult issue for women who are members of racial or ethnic minorities.

He adds that physicians must also make an extra effort to make sure they are understanding the concerns of patients with disabilities and cognitive impairments. “It really takes time, and that's the one thing the clinicians today don't have,” he says.

Even acknowledging those understandable pressures, Schabacker says it’s critical for physicians and clinicians to take a breath and make sure that they are really listening to their patients, or the family members or caregivers. He says it’s critical to ensure patient safety.

“You can learn a lot, and at the end, you’re actually going to save time, and you're going to prevent patient harm,” he says.

Hospital and health system executives can do better by making sure that clinicians have sufficient time to have a conversation with their patients.

“You need to create an environment where that kind of positive interaction with the patient is rewarded,” he says.

And there’s no getting around the need for appropriate staffing, he adds.

“The cost is going to be much lower because we're not going to have as much misdiagnosis. We're not going to have as many wrong treatments, ignored treatments. Patients are not going to go to multiple providers because they finally want to get heard,” Schabacker says.

ECRI’s list covers concerns regarding several different facets of care, including the use of artificial intelligence in healthcare. ECRI names insufficient governance of AI in health care as the second leading threat to patient safety this year. AI also ranked near the top a year ago on ECRI’s list.

The growing prevalence of medical information ranked third on the list. Schabacker warns of the dangers of consumers trusting what they see on social media or a web article rather than information from clinicians and healthcare experts.

“Just because something has 100,000 clicks doesn't make it right,” he says. “There's a lot of information there which gets disseminated, which has no scientific evidence based backup whatsoever.”

Here’s ECRI’s full list of its top concerns for patients in 2025.

ECRI’s Top 10 Patient Safety Threats

1. Dismissing patient, family, and caregiver concerns;

2. Lack of governance of artificial intelligence;

3. The spread of medical misinformation;

4. Cybersecurity breaches;

5. Caring for veterans in non-military health settings;

6. Substandard and falsified drugs;

7. Diagnostic error in cancers, vascular events, and infections;

8. Healthcare-associated infections in long-term care facilities;

9. Inadequate coordination during patient discharge;

10. Deteriorating working conditions in community pharmacies.