Apr 5, 2010

Doctored to Death?

What is a Doctor Junkie?

commenter on the Medical Mafia post brought up the subject of doctor-junkies, and readers seemed fascinated by the idea.

Yes, doctor-junkies are real and they are everywhere!

Just as Doctorphobia is hazardous to your health, Doctorphilia can be equally disastrous.

Any regular reader of AskAnMD is aware that while MDs are useful, we can also be dangerous. An addiction to doctor-visiting will lead to lots of risky tests and medicines you don't need. Too much doctoring can take you to an early grave and make you miserable on your way there.

Who are these Doctor-Junkies?
Doctor-Junkie: (n) -a person who believes that every uncomfortable or unusual physical sensation must be evaluated by a doctor.
While most hypochondriacs are doctor-junkies, not all junkies are hypochondriacs. Some doctor-junkies aren't paranoid they have a horrible illness, but just feel every little thing must be "checked out."

Dangerous Doctorphilia is often an inherited condition. Doctor-junkies start out as those kids whose parents rush them to a doctor every time they sneeze or scrape their knee:
Once a mother brought her child to Doctor D's ER because the toddler had made an especially loud sigh. "A sigh?" I asked. "Yes, like this" and she made a sighing sound "so I just wanted you to check his lungs." Doctor D assured mom that we all sigh on a regular basis, but perhaps this sigh was louder because of her child's frustration that he had a mother with nothing better to do than gauge the volume of his sighs. She demanded a Chest X-ray just to make sure. Then Doctor D let out a loud sigh of his own.
You would think after a childhood spent in ER and clinic waiting rooms that someone would want to escape the world of needles and medicines, but the junkie is hooked by the time they reach adulthood. Any runny nose or sore muscle and the doctor-junkie gets that overpowering urge to visit somebody in a white coat quick. The doctor-junkie isn't satisfied with just an exam and reassurance, "No doc, I've been waiting a long time to see you so give me the good stufflab tests, X-rays, and lots of pills!"

To the doctor-junkie no symptom is too mild or too brief: every physical discomfort needs blood work and prescription medicine ASAP. If you doctor's office is on lunch break then junkies call an ambulance for that mild sense of nausea!

In addition to wasting billions of dollars, all those visits likely shorten the lives of the junkies. Radiation from imaging studies leads to cancers. Lab studies eventually uncover benign abnormalities that junkies need fixed. Junkies get some really nasty side effects from meds, because they've often been prescribed every medicine in the pharmacy.

Rather than forcing the junkie at rock bottom to change his ways, being harmed by healthcare has the opposite effect: a doctor-junkie who is sick from over-doctoring feels the compulsive need for more and more and more.

Who is to blame for this epidemic of Doctorphilia?


Yup, it's us. We have the stuff that junkies crave, and docs give out unnecessary care like candy till we get everybody hooked.

Why shouldn't we? Docs get paid to see people whether they are really sick or not. A proper exam followed by educating a concerned patient is difficult and time-consuming, while ordering tests and writing prescriptions is just so quick and easy. Doing unnecessary care and writing unnecessary prescriptions keeps patients happy with us because they feel they are getting something done.

Plus, it's nice to feel needed.
I know a doctor who shall remain nameless that gives antibiotics to every single person with a runny nose. Now almost all runny noses are caused by mild viruses that cannot be cured by any medicine. Dr. Zpack gives everybody a useless antibiotic and they all assume that the medicine worked when the symptoms resolve on their own. His patients are apparently unaware that human beings have immune systems. Dr. Zpack's junkie patients love him because he always "cures" their infection, and it's good business for him because half his visits are simple colds he can easily "fix" with one prescription. When Dr. Zpack's office is closed his patients panic and rush to the ER at the first cough. He's a nice old doc, but who knows how many superbugs and dangerous reactions have originated with Dr. Zpack's prescription pad?
The fact that doctors give out unnecessary care immediately legitimizes it. Patients accept that it must be safe and necessary if doctors order it. Some patients casually dabble in being over-doctored, but some susceptible patients fall over the edge into full-fledged addiction.

The Addiction Gets Ugly:
It's a win-win situation for the dealer and the junkie until something goes wrong: The junkie gets too demanding or overdoses on unnecessary care resulting in an iatrogenic injury. Then Dr. Dealer freaks out and cuts off the junkie cold turkey.

Doctor D has seen it too many times: panicked patients in withdrawal from over-doctoring pitching fits in the ER that they have to wait an hour to be seen for their runny nose.

Coming to Doctor D's office (or his blog) is like detox for doctor-junkies. Appropriate medical care is often a shock to the doctor-junkie's system. Doctor D has to explain to recovering junkies that the human body is actually capable of healing itself. Who knew?
Fortunately Doctor D has a 12 step program for the Doctor-Junkie epidemic. Tune in next week for my prescription for curing the over-doctored!
What do you think? Have you or loved one ever suffered from Dangerous Doctorphilia? How did you recover? Do you blame MDs for this problem?

Did you miss Doctor D? Where were you when you first heard the word iatrogenic? What other irreverent medical topics should this blog tackle?

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


Albinoblackbear said...

Welcome back. It as a difficult cold-turkey withdrawal when you up and left the blogosphere 40 days ago. I've only just gotten over the chills, nausea, and hallucinations, and now you're back!

Hope you had a great break and wonderful Easter with your family. :)

WarmSocks said...

Welcome back, Doctor D! Hints for getting better medical care, vocabulary enrichment, a peek into a doctor's thinking, entertainment... this blog has a little bit of everything!

Nuclear Fire said...

I'm glad you're back. Thanks for the useful post.


Welcome back Dr D I hope the sabbatical went well! Great post:)

Maha said...

Finally Dr D posts again! :D

A childhood friend of mine is a self professed hypochondriac/doctor junkie. She's learned to not ask me any more questions because once I told her that her leg pain could be a DVT (never mind that we went skating for the entire day in badly fitting skates) causing her to have a panic attack of epic proportions. I've never felt like a bigger jerk.

expwoman said...

Not all "doctor junkies" lack insight into the cycle of anxiety-reassurance-increased anxiety.
I have a love-hate relationship with doctors--part of the suffering that comes with OCD is having some awareness that my fears are irrational, but still feeling overwhelming panic, and that going to the doctor will give a quick hit of relief, but almost immediately rebound into an even bigger fear. My mother has OCD and monitored my health intensely, so I had a combination of learning and genetics and by age 9 I was monitoring my own body. I'm in therapy with a cognitive behavioral therapist who does exposure and response prevention. Learning to live with uncertainty is really hard but the rewards are great. I wrote about my latest exposure challenge--taking iron and waiting 6 weeks to recheck my hemoglobin without hours of websearching. http://exposingocd.blogspot.com/2010/04/dialogue-with-ocd.html

Grumpy, M.D. said...

Part of the problem is patients often don't want to accept the answer of "it's not serious", no matter how many tests have been negative. So they keep trying to find a doctor who will find something.

queenofoptimism said...

Wow, Doctor D. what a great opening day post. I'm starting to think your 40 days were used to craft some awesome ideas for posts as well. ;)

And now a comment directly to Dr. Grumpy - part of the problem is that when a patient has many tests that are negative, the doctor doesn't want to accept that there still may be something wrong. I realize that I'm likely not going to die from my current problems so in that sense, they are "not serious"; however, the fact that I develop a severe leg limp and arm weakness from use/movement to the point of needing help to put on my underwear and to shower is serious to me.

Nurse K said...

A nurse at work re: Sputum: "If it's green, it must be seen!"

Even doctors still believe this crap. They'll ask if the patient has green sputum (they always do), and if yes, then an antibiotic is given. Whatever. Green doesn't mean anything, people!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! ! ! 1!

Rachael said...

my husband is a doctor junkie. I tried to talk him out of it, but he went to the doctor for a sinus infection! AND the dr prescribed him an antibiotic, a nasal spray and allergy pills. I mean, really?

Dani said...

I think sometimes it can be hard to find that balance. For those of us with limited medical knowledge, it can be hard to decide when to go to the doctor and when not to. I think I make the wrong decision every time. Complete opposite of what I should do, If I do go there is nothing wrong... and if I don't I probably should have. I think trying to decide when to go can lead some people to going MUCH more than they ever should have.

Glad you are back :)

Doctor D said...

Green Sputum! OMG call the ambulance!

QUEEN: I'm not saying all undiagnosed or undiagnosable illnesses are doctor junkies coming in for silly stuff. I know your situation and your symptoms are the sort that DO need evaluation even if the evaluation ends up negative. You don't go in for minor stuff. I wish you had only minor issues--enough to qualify you as a doctor-junkie.

DANI: Excellent point! Without medical knowledge it IS hard for people to know what is serious and what isn't. This is why most doctor-addiction is the fault of MDs. We don't educate people like we should. We bitch and moan about people coming in for minor stuff, but we reinforce that behavior by not educating people on how to take care of minor stuff without a doctor.

Motherhood for the Weak said...

I hate going to the doctor but it's all I seem to do anymore so I feel like a junkie.

I'm trying to get away, but my body won't cooperate.


Pissed Off Patient said...

Enjoy your blog! I really like your perspective. I have started a patient blog if you are interested and have linked to you.

PO Patient

Old MD Girl said...

I think think part of the problem with my generation is that we grew up with drs who really WOULD give you abx for a cold or a cough. Then the culture changed (based on the discovery of superbugs) and we started going to drs who were trained with this new knowledge in hand. No more abx!!! Panic set in.

Truthfully, I think some patients who see the dr for every little thing are a little nuts -- addicts if you will -- but others just don't know that you don't need to do to the dr for every fever or cough. They did it when they were kids, why would it be different now?

shrtstormtrooper said...

Good to have you back after the lent season, Dr. D. Now go forth and educate the public on doctor junkies and how to break yourself of the habit!

Anonymous said...

Welcome back, Dr. D! Missed you, I did. But I'm not a doctor junky.

My husband, however, IS a borderline doctor junky. He has a myriad of aches, pains, and inexplicable symptoms along with a couple of real conditions. Because there are so many mystery pains, though, he's been given a huge number of prescription meds over the last couple of years, most of which don't seem to have much effect. Now I worry that some of his symptoms are the result of bad drug interactions. It's a frustrating and sad situation, because this is man who was healthy as the proverbial horse for most of his life. He used to backpack, fish, and Xtreme garden (moving boulders, etc). Now he does very little.

Sometimes it's hard to take him seriously when he complains. I feel bad when that happens, because I have RA and I know how frustrating it is to hurt and not have your family and friends understand, particularly when you were FINE a few hours before. I'm rambling on, here, but I AM leading up to a question:

When someone has pain or other symptoms of illness, and the cause hasn't been successfully diagnosed, even after seeing several different docs and going through all kinds of tests, what can that someone do? My husband obsesses and gets depressed, but so far he's managed not to rush off to the doc every time.

I realize that I'm asking a question that's almost unanswerable. But since you're a doc, and you seem to be a good one, what are your thoughts on this? Thanks. And once again, welcome back. Your posts are always thought provoking, humorous and very well written.

tracy said...

Missed you sooo much, Dr. D!

i'm a "Doctor Junkie" in that i w i s h i could see my doctor more often, but i don't...i just w a n t to. i see him maybe once every couple of years or so or if i'm "lucky" enough to have something go wrong enough to warrant a visit. Maybe if he weren't so kind...

"Junkie" in my mind,

tracy said...

PS LOVE the picture!

Anonymous said...

When I was a child, we never visted the doctor for a health checkup, colds, measles, mumps or anything less serious than a amputated apendage... and then only if you could find what was cut off because there is no sense going to the doctor if there was nothing to sew back on! Just kidding about the last one.

sara r. said...

A friend of mine recently had her thyroid removed a few months after the birth of her 3rd child, which makes me wonder if she was actually suffering from the Temporary condition of postpartum thyroiditis, as I did after my first pregnancy. I finally went to the doctor when I lost 10 pounds in 2 weeks and was BURNING UP, but then did some research and waited it out. After 3 months I was back to normal. My friend, who is known as a hypochondriac, ended up weaning her 5-month old and having surgery. I can't help but wonder if it was really necessary, and if her pattern of going to the doctor led to a hasty diagnosis of a thyroid disorder like Graves' or Hashimoto's.

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