Apr 13, 2010

The Cure For Doctor Addiction!

Last week Doctor D told you about the dangers of doctor addiction. Today he's going to give you a twelve (actually 5) step program to save junkies!

Doctor Junkies feel an irresistible compulsion to see an MD every time they feel any physical discomfort form their bodies, resulting in risky tests and medicines as well as financial ruin for junkies and the healthcare system. While some responsibility for the problem rests with the junkies themselves, a lot of the blame for this can be laid on doctors who can be dealers and enablers for this deadly addiction.

Doctors are aware of the junkies in their lives. If you hang out with doctors (or read their blogs) you hear them complaining about junkies hitting them up for unnecessary care. "This patient of mine called an ambulance for a stubbed toe!" We gripe about our junkies, but we don't often propose solutions to improve the system that created this problem.

Well, today Doctor D is going to change that!

Doctors must take action to stop this madness before it gets out of control!

Here is Doctor D's plan to deliver our patients from the sad bondage of addiction to unnecessary medical care and lead them to the promised land of wellness!
1) Preach the Natural Healing Power of the Body.
Here's a big secret we don't often tell patients: the human body has an almost magical power to cure itself when infected and heal itself when injured! Who knew? In fact, before modern medicine this secret self-healing power of the body was the only thing that cured sick humans, and believe-it-or-not the human race survived. Modern patients and modern doctors often forget the human body has the ability to heal itself. Doctors are trained to intervene in the rare situations when body's own self-healing fails, but before long we find ourselves intervening when the body is doing a fine job on it's own because we only thing of medical cures not the body's own self-healing.

Doctors need to be spokespeople for the body's own immune system! We should spread the word about the body's abilities. We must acknowledge that even in our "medical miracles" the body does most of the healing on its own.

If MDs preach the amazing healing ability of the body, doctor-junkies will believe their body can handle that runny nose a few days without running to a doctor.
2) Grow a Pair and Don't Piss Your Scrubs at the Mention of Lawyers!
Most docs could easily educate patients on what symptoms usually aren't serious. Heck, we could give you a handout of all the symptoms that don't require a doctors visit if they are short lived: runny noses, coughs, joint aches, low-grade fevers, diarrhea, feeling yucky, etc. We could alleviate your anxiety with one therapeutic dose of knowledge.

Why don't we?

Doctors are terrified the information we give out will be used against us by blood-sucking lawyers.

We won't tell you to stay home with that runny nose because a nasal drainage could also be a symptom of a one in a million cerebrospinal fluid leak. We get terrified of missing zebras, so we kill a lot of horses. Fear of missing a rare diagnosis drives MDs to do irrational and dangerous things. We whip up doctor-junkies into a panic over their harmless symptoms and send them like lemmings over the cliff of over-doctoring.

Medicine is about taking risks. We risk your life every time we write a prescription or order a test. We should also be willing to take a risk by not doctoring conditions that are likely benign. There is risk either way, over-treatment protects us from lawyers, so physicians kill lots of doctor-junkies every year with big work-ups that are solely done to satisfy lawyers. Since we take risks either way, then we should practice with common sense and share our reassuring knowledge that most mild symptoms aren't dangerous with patients.

If blood-sucking lawyers want to sue me for using common sense, fine! Bring it on, bitches! Doctor D is ready!
3) Believe in prevention
Proper primary care can often prevent illness or catch it before it becomes serious. Fighting disease is only a secondary goal of medicine. Preventing serious illness is the real goal of primary care.

What does this have to do with doctor-junkies?

Doctor D has noticed a pattern that the MDs that give out the most unnecessary care to doctor-junkies are the same ones that suck at keeping their patients up to date on their preventive care. Coincidence? Nope.

Dangerous Doctorphilia is a need for the reassurance of receiving medical care. Preventative care fills this need in the safest possible way. Preventative care recommendations are constantly evaluated to insure their benefits far outweigh their risks. Appropriate preventative care and regular physicals can rehabilitate a former junkie. Their body has been checked for and vaccinated against most common problems. With prevention in their lives patients can have the confidence to weather minor symptoms without running to the ER.
4) Talk About the Risks of Medical Care.
Most patients don't realize that even appropriate medical care can be dangerous. Doctor-junkies love pills, and tests, and X-rays. The more the better! I've had junkies accuse me of trying to deny them the good stuff they are due when I'm just trying to protect them. "Order more, doc. I've got insurance!" WTF?

The best time to educate patients is when we are do appropriate interventions.

Many people at some point in their lives get a serious illness that requires aggressive care. If the power modern medicine helped their serious illness, they assume the same weapon should be used on their minor symptoms.

So, Doctor D actually educates people about the risks of care when he is giving it appropriately, "Antibiotic have some very real risks and I wouldn't give them if I didn't think your infection was serious." A word like this can save a patient from the frustrating and dangerous life of a doctor-addict who will beg for antibiotics every time they get a cold.
5) Educate Fearlessly!
Ultimately the cure for doctor-addiction is education. Instead of laughing at doctor-junkies' errors MDs should show them the light. Most doctor-junkies aren't stupid or irrational, they are just misguided about the proper use of medical care. It will take time and a bit of risk for doctors to show junkies a better way, but it is worth it.

After all, they are our junkies. Who is going to help them if not for doctors?

What do you think? Do you think this plan could will stem the tide of doctor-addiction? Have you ever had a doctor educate you on the power of your immune system or the risks of medical care? Did it help you avoid unnecessary medical care later?

As always Doctor D loves to hear your thoughts in the comments!


Pissed Off Patient said...

I really enjoy your perspective--you sound like an excellent doctor whose patients are lucky to have him.


coulrophobic agnostic said...

My doctor is a strong believer in #1 - he'll give you something for symptoms that are really bothersome, but mostly he tells you to wait a couple of weeks and call back if it's not gone. (Yeah, call - he's awesome about talking to patients over the phone instead of making them come in for things like "I've had diarrhea for a week and I think I might turn inside out, should I worry?" ...yeah, there was a stomach bug that was going around a couple years back, I called to make sure I shouldn't be worried - I know it seems obvious, but damn I felt like shit - he told me he'd been getting a million identical complaints, so pop some Immodium and wait it out. I wish more doctors did that.)

Anonymous said...

From the title I thought you'd suggest docs start adding a DRE to every visit - that'd cure some patients for sure!

Dani said...

I think you did a good job! I especially like both 1 and 2. Sometimes as the patient(even a non doctor-junkie) it can be easy to forget that the body can do a lot of the work itself. I mean who doesn't want an answer that seems easier or faster, right? Even if it really isn't.

I hate law suits, lawyers, and all of that crap. I think it is so sad that doctors and other health professionals have to worry so much about it that it can influence the way that they practice medicine :(

HugeMD said...

Many, many good points. I've found a frequently effective cure for excessive requests for x-rays and CT scans--just start talking about radiation.

Maha said...

I would love to work with a doc like you! I think it sucks that so many docs simply don't get time to properly educate their patients despite their best intentions. Some days it seems easier to order some labs just to reassure the patient but in the end that ends up being a drain on the system as a whole and further perpetuates the doctor junkie cycle.

bb said...

I admit I do not understand people's need to see a doctor for every sniffle (or showing up in the ER over a "sigh"). It just seems like it would be so much work to call, make an appointment, reschedule a work day or one's schedule just to be seen. I think perhaps we as Americans have become so dependent on technology that we can't do some things for ourselves or have lost the faith that our bodies really do an excellent job at healing if only given the chance. I know I am one of those "dependent Americans" though not with respect to seeing a doctor over every little thing. I realized how dependent I am when my dishwasher broke and before I could get another one installed, I went to the store and bought a bunch of paper cups and plates because I told myself I was too busy to wash dishes. I know, that's pitiful -- probably as pitiful as the lady who brought her child to the ER because her child sighed (though mine was less expensive).

With such excellent medical care we have in this country, I'm wondering if people really don't know how capable our bodies are at healing itself. There's always someone that can fix it so we've become dependent.

I admit I am dependent on my vet. Since payment is due before leaving the vet's office, I am more in tune as to what needs medical care and what does not. I wait and see how my pet is doing unless it's an obvious medical emergency. I also think if we're not paying for something directly, then we're more likely to be wasteful and dependent.

I think you're right and education would go a long way especially if people were educated that giving their body a chance to heal is better for them in the long run.

Anonymous said...

I think you made some really good points.

I just get frusterated because I have about three chronic conditions (and I'm a young person!), and I have a hard time differentiating from my "normal" trouble breathing and the "get thee to an ER" trouble breathing. SInce I get wheezing whenever I get sick, it makes me feel like a doctor junky even though I'm not. Until I found my current pulmonologist my docs just dosed me up on prednisone, and I took it out of fear (you know of not being able to breath), to just get by...so I'm doing better now that this one doc took the time to work with me. It just makes me mad that it took me that long to find a doctor who was willing to convince me that the risks of taking pred were larger than the risks of not breathing. And that no meds would fix the problem I have with my trachea (which three other lung doctors didn't find).

So now I'm doing pretty good that I'm not afraid passing up on the pred. will leave me with lung damage due to uncontrolled asthma (which I don't have). Details.


Doctor D said...

Anonymous 12:47-

It is not the number of visits that distinguishes a doctor-junkie. It is rather the number of visits for minor problems.

The inability to breathe is a pretty major issue. People with severe chronic respiratory problems may have to see their doctor a lot, but not be junkies.

Anonymous said...

"It is not the number of visits that distinguishes a doctor-junkie. It is rather the number of visits for minor problems.

The inability to breathe is a pretty major issue. People with severe chronic respiratory problems may have to see their doctor a lot, but not be junkies."

Thanks for this! I really enjoy your blog. Sometimes I wonder if I missed my chance to become a doctor junkie LOL...kind of like I missed my chance to prevent certain issues, as in I already have more than one chronic medical condition. Although it is ironic, as I do believe strongly in prevention and appreciate that you enjoy educating patients!


Anonymous said...

OK Dr.D another question related to Anonymous's comment. I have asthma and it seems like my chest is always tight and I always feel like I'm having trouble breathing. How do I know when to seek medical help? When they told me I had asthma, I was surprised, because I guess I had gotten so used to not being able to breathe that it became normal for me. I don't want to be a whiner, but at the same time, I like breathing. Help! (Oh, and thank you!)

Doctor D said...

Dear Anonymous 10:15,

Unfortunately giving advice to patients I have never examined on when to see a doctor when you're always having trouble breathing is outside of the scope of this blog.

You should definitely discuss this with your doctor, though.


As a patient (at times) I go through a personal check list before ever approaching a Dr.
Once I have gone through the check list I ask myself "Is this bearable and can I lead a normal daily life with it", I then wait and see for usually a week.

If my check list and research, or a second casual opinion can't resolve the issue or come up with a rational explanation for the 'woe' and it stops me living a normal life only then do I seek a Dr's opinion.

Some times we have to rationalize what our body is doing. For myself going to the G.P is expensive and although I have seen the same Doc for 24 years I also am aware that their level of expertise is limited when it comes to my condition. So I will see my G.P (general practitioner maybe once every three months or so.

Of course my fear of the Hospital has kept me away from there for about five months and counting, so a heck of alot of rationalizing and symptom tx has gone on.
As a patient be wise, calm down and try and work out rationally what the problem is, have you had this pain symptom before and did it resolve without any intervention.

Post a Comment