Our headline finding is that people with GAD are 2 to 3 times more likely to experience either medical gaslighting or diagnostic overshadowing when reporting their physical health problems to HCPs, when compared to people who do not have GAD. Aware of this, we also found widespread HCP desire to better understand and address this difference and its inequitable outcomes. Around 4 out of 5 of all GPs wish to enact the ideas proposed in the survey (suggestions that were also rated highly by GAD respondents). A majority of GPs acknowledge that when presenting with physical health complaints, people with GAD require particular attention and need more consultation time.
Nevertheless there are limitations to what can be done. GPs find it hard to enact and sustain dedicated modes of practice consultations for people with GAD and other anxiety conditions for two reasons. First, limited resources and operational constraints constrain their capacities to adapt the form and extend the time of patient consultations for GAD patients in primary care. Second, bespoke consultations are difficult to plan and undertake because of the challenges of a) stratifying GAD patients prior to their consultation, b) isolating anxiety behaviour and symptoms during a consultation, and c) incorporating non-clinical factors when making a diagnostic assessment.
In the final section, we explore the clinical implications and possibilities for addressing MG and DO in the clinical setting.