‘Dismissing Patient and Caregiver Concerns' Tops Annual List of Patient Safety Threats
Dismissing patient, family, and caregiver concerns tops ECRI’s 2025 list of the most significant threats to patient safety. The global healthcare safety nonprofit organization says time and resource constraints make it increasingly difficult for some clinicians to provide empathetic care that addresses patient and caregiver concerns, potentially leading to missed and delayed diagnoses.
More than 94% of patients reported instances when their symptoms were ignored or dismissed by a doctor, according to a survey from HealthCentral. ECRI says when concerns go unaddressed, patients and caregivers feel like they’re experiencing “medical gaslighting,” which the American Journal of Medicine defines as “an act that invalidates a patient’s genuine clinical concern without proper medical evaluation.” Unlike the popular usage of the term “gaslighting,” medical gaslighting is not considered intentional, and clinicians are often unaware they exhibit the behavior, ECRI experts say.
ECRI says medical gaslighting can happen when clinicians are rushed for time, have biases that reflexively attribute symptoms to issues like mental illness, age, or weight, or make cognitive errors like interpreting new information in a way that confirms a previous diagnosis. This can lead to a missed diagnosis, delayed treatment, and decreased trust between patients and their healthcare providers.
“Most clinicians have a deep commitment to healing and protecting their patients and would never intentionally make a patient feel unheard, but it nevertheless happens with alarming frequency,” said Marcus Schabacker, MD, PhD, president and chief executive officer of ECRI. “Providing high-quality healthcare starts with truly listening to patients. When we value their input, we gain critical insights that improve patient outcomes and build trust. A healthcare system that prioritizes patient voices is one that delivers safer, more efficient, and more compassionate care for all. Unfortunately, too many clinicians are operating under time and resource constraints that fuel substandard care.”
ECRI experts say solutions require a holistic approach that considers how all aspects of a health system—including leadership and governance structures, patient engagement, workforce wellness, and training infrastructure—promote safety.
“Patient safety events are not isolated incidents. They are often products of the system that clinicians and patients operate within, and how that system supports the people it serves,” said Shannon Davila, MSN, RN, CPPS, CIC, CPHQ, FAPIC, executive director of total systems safety at ECRI. “Tackling threats to patient care requires rejecting the current fragmented approach and designing systems that promote a true culture of safety.”
Patients for Patient Safety (PFPS) US President and CEO Sue Sheridan will join ECRI’s webinar on March 18 at 1 pm ET to discuss the risks of clinicians dismissing patient and caregiver concerns. PFPS US is a network of advocates and organizations focused on making healthcare safe, led by people who have experienced medical error as a patient or in their families. Register for the webinar.
ECRI experts offer systems-based recommendations to help clinicians actively involve patients in their care, including examining scheduling policies to ensure clinicians have enough time with patients, utilizing empathetic listening techniques, and providing education on conditions that are often misunderstood or minimized, like endometriosis.
The report provides similar systems-based solutions for each of the top 10 concerns. The 2025 concerns in ranked order are:
- Dismissing patient, family, and caregiver concerns
- Insufficient governance of artificial intelligence
- Spread of medical misinformation
- Cybersecurity breaches
- Caring for veterans in non-military health settings
- Substandard and falsified drugs
- Diagnostic error in cancers, vascular events, and infections
- Healthcare-associated infections in long-term care facilities
- Inadequate coordination during patient discharge
- Deteriorating working conditions in community pharmacies
ECRI’s 2025 report includes recommendations for healthcare organizations to create organizational resilience to navigate the identified threats and strive for total systems safety.
Download the report.
ECRI and Institute for Safe Medication Practices (ISMP) analyzed a wide scope of data to identify the most pressing threats to patient safety, including scientific literature, patient safety events, concerns reported to or investigated by ECRI and ISMP, client research requests and queries, and other internal and external data sources.
Contact
Questions? Email clientservices@ecri.org. Media inquiries should be sent to Yvonne Rhodes, Associate Director of Strategic Communications, at YRhodes@ECRI.org.
About ECRI
ECRI is an independent, nonprofit organization improving the safety, quality, and cost-effectiveness of care across all healthcare settings. With a focus on technology evaluation and safety, ECRI is trusted by healthcare leaders and agencies worldwide. ECRI is designated an Evidence-based Practice Center by the U.S. Agency for Healthcare Research and Quality. ECRI and the Institute for Safe Medication Practices PSO is a federally certified Patient Safety Organization as designated by the U.S. Department of Health and Human Services. In 2020, ECRI acquired ISMP to create one of the largest healthcare quality and safety institutions in the world. Visit www.ecri.org.