Tia's 2024 Health Outcomes: A Closer Look at Health Equity, Medical Gaslighting, and the Power Gap in Healthcare

In 2023, Tia did something bold. We held ourselves accountable.

While the business was bustling with growing membership and more appointments, we wondered if our patients were also bustling.

Tia was getting healthier. But what about our patients?

We wanted to know if our new model of “Care for Women” was actually working; if we were closing the healthcare gap and improving health inequities. What were we doing right? What could we improve? Where were the opportunities for more compassionate care on women's health?

To answer these questions, we started asking questions and tracking data on several key areas of healthcare, including health equity, preventive services (like cervical, STI, and HIV screening), chronic condition management, mental health assessment, and quality of life.

That was the start of Tia’s annual “Women’s Integrated Primary Care Outcomes Report”.

Here’s a snapshot of our results in 2024:

• 85% of Tia patients received cervical cancer screening. (The national average is 36%.)
• 89% of Tia members were screened for depression. (The national average is 49%.)
• 60% of Tia patients maintained optimal control of diabetes (The national average is 53%.)
• 72% of Tia members reported an improved quality of life.
• Health equity also scored high: 64% (Tia) v. 46% (national average).

From the early stages, Tia put a high priority on advancing health equity. We invested in collecting, tracking, and reporting health quality data by race and ethnicity to ensure that quality of care outcomes were equitable. In 2024, the report showed that we achieved a balanced performance across diverse race and ethnic groups – and surpassed industry benchmarks.

This article represents the first in a series that aims to explore the 2024 Outcomes Report at a deeper level. First up? Health Equity.

A Cry for Health: Why Health Equity for Women Matters

“Equal Justice Under Law” is a phrase engraved above the front entrance of the United States Supreme Court. It’s a bold idea on paper (or, you know, chiseled into rock). But, in reality, there are numerous human factors that influence a person’s experience and treatment under the law.

Unfortunately, the same can be said about healthcare. Everyone SHOULD receive equal treatment “under the knife” or in an exam room, but the reality of the situation is often a bitter pill.

Despite advances in medicine, too many people still face unequal treatment in the healthcare system and encounter systemic barriers to medical care – especially women, people of color, and members of the LGBTQIA community.

In a 2022 report, nearly one-third of women reported feeling dismissed by doctors during their most recent visit:

• 46% of women (18-35) reported having a negative interaction with a healthcare provider.
• 15% of women felt disbelieved.
• 19% of women said doctors made assumptions without asking questions.
• 13% of women felt personally blamed for their healthcare issues.

Turn Off The ‘Light’: Medical Gaslighting and How it Impacts Healthcare

The term “gaslighting” comes from a 1938 play, “Gaslight”, in which a husband manipulates his wife into doubting her sanity. He’s so certain of his version of the truth that she begins questioning her own experience and reality.

Medical gaslighting occurs when a healthcare provider invalidates, downplays, or dismisses a patient’s genuine medical concerns. This happens when a doctor minimizes symptoms, refuses to conduct exams, or blames those concerns on mental health issues without proper evaluation.

If you’ve ever mentioned a symptom and had a provider brush it off or say: “It’s probably just stress” or “It’s all in your head”, you know what medical gaslighting is. It’s a harmful experience and all-too-common habit that delays diagnosis and treatment, erodes trust, and leads to poor health outcomes – especially in women.

Medical gaslighting doesn't just hurt your health; it harms public health.

This lack of health equity and these barriers don’t just shortchange quality healthcare for women, they discourage getting regular healthcare at all – which has led to higher rates of mental health issues, autoimmune conditions, and poorer overall health outcomes in women.

See for yourself:

• IN 2024, 20% of US women didn’t routinely see a PCP and 50% didn’t have an OB/GYN.
• As of 2022, US women had a life expectancy of 80 years – the lowest among high-income countries.
• The United States reports the highest rate of avoidable deaths among women (270 per 100,000.)

But women aren’t the only ones paying a big price for this healthcare inequality, research shows that families, workplaces, and communities are less healthy (less productive, less happy, less fulfilled) when women’s healthcare needs aren’t being met.

So, it’s not ‘someone else’s’ problem. We all have a responsibility to ensure women get better access to care and get better treatment within the healthcare system.

Mending the Gap: Empowering Yourself in the Exam Room

Healthcare providers know a lot and clinical experience matters. But so do you. And no patient should ever feel dismissed, disrespected, or invisible during an exam.

You have the right to be heard and involved in every health decision. You have the autonomy and agency to advocate for yourself at the doctor. Here are some tips to feel more empowered in an exam room:

Before your visit…

• Keep track of your symptoms using a journal or app. Patterns are important when it comes to diagnosing disease, and it’s easy to forget something important in the room.
• Write down questions and concerns. It’s okay to do some research and talk to friends, but leave room for your provider to use her clinical experience too.
• Bring previous test results and records, especially if you’ve had recent blood work or imaging to investigate medical conditions.

During your visit…

• Be confident and speak with clear language. Some chit chat is fine, especially if it makes you and your provider feel more comfortable, but don’t let it distract you from the mission.
• Don’t be afraid to ask your healthcare professional to repeat herself or clarify something. It’s also okay to speak up if you don’t feel heard. Honest and open communication is key.
• Take notes or bring someone with you for support. A trusted friend or family member can be a huge asset if you feel like you need someone to have your back.

After your visit…

• Make sure you understand the follow-up plan. Ask for copies of your visit summary and test results (when they become available).
• Learn about resources, like patient portals, that allow easy access to information.
• Review the encounter and check-in with yourself. If something felt ‘off’ during your visit, seek a second opinion. Healthcare professionals are busy and have bad days – but if the problem persists, it may be time to move on.

In general, your provider should:

• Be polite, respectful, kind, curious, and compassionate.
• Ask open-ended questions and have the patience to hear you out.
• Express empathy and validate your concerns.
• Involve you in decision-making and tailor your treatment.

Conclusion: Your Voice Matters

Every woman deserves to be heard and respected in healthcare. You deserve a high-quality healthcare experience in the exam room that listens, supports, and empowers you – at every stage of life. Whether it’s getting an overdue Pap smear, seeking support for mental health issues, or simply going for a routine check-up, your healthcare journey starts with a single step: speaking up for yourself.

If you’ve ever felt underwhelmed during a doctor visit or over-exhausted by the system, perhaps it’s time to give Tia a try. We have an innovative, inclusive, and integrative approach to women’s healthcare that engages people – especially those from demographics that are often underserved in preventive medicine and primary care. Once patients join Tia, they enjoy life-saving preventive care at 2-3 times the national average while also managing chronic health problems that improve outcomes over the long term.

Tia has worked hard to build a care model and care team with health professionals who understand the challenge and never underestimate the mission. We know the best healthcare isn’t just about helping and healing you, but also about hearing you.