The mental health of doctor-shoppers: Experience from a patient-led fee-for-service primary care setting

Abstract

Background: doctor-shopping may reflect unmet patients needs and place a significant burden on health resources; however little is known about its underlying reasons and how it relates to mental illness and its recognition in an open access fee-for-service setting. Among patients with a common mental disorder, 'dissatisfied' doctor-shoppers were significantly more likely to be recognised as cases by the GP, adjusting for covariates (OR=6, 95% CI: 2.1-17.2). This was not the case for those doctor-shopping for practical reasons alone.Conclusion: doctor-shopping behaviour is associated with higher rates of mental illness and, among cases, an increased likelihood of recognition by the GP, only however for doctorshoppers dissatisfied with previous care. This suggests a benefit to letting patients choose their GP as is the case in France and change if not satisfied.

Frequent attendance in family practice and common mental disorders in an open access health care system

“…Because of the specificities of their practice (limited or no waiting area, or waiting time, few spaced-out consultations, many patients not in inclusion criteria), we drew a parallel list of GPs with an alternative practice style, who were contacted separately and selected for convenience purposes. In all, 46 FPs participated, 41 (27 urban, 14 semi-rural) with a classic" practice-style and 5 (4 urban, 1 semirural) with an alternative practice-style [27,28].…”

“…This could be because patients in France at the time of the study were able to consult any FP at will. We previously found on data from the same study that patients with a common mental disorder (depression, anxiety, panic or somatoform disorder) who had doctor-shopped over the previous six months were more likely to have their psychiatric disorder detected on the survey day, but only if they had changed FP because of dissatisfaction with previously received care [28]. The lack of association between chronic disease status, physical health and FA would therefore reflect appropriate management of these conditions in general practice, with patients being able to choose the FP which suits them best.…”

“…The study limitations are described in detail elsewhere [27,28]. The main limitation is the low (33%) but common FP participation rate [35] which may have led to the selection of FPs particularly interested in mental health issues.…”

Doctor shopping by overweight and obese patients is associated with increased healthcare utilization

“…This variable was dichotomized as absence or presence of any mental health diagnosis. We adjusted for mental health diagnosis as it has been previously associated with doctor shopping (22).…”

"Seeing a doctor is just like having a date": a qualitative study on doctor shopping among overactive bladder patients in Hong Kong

“…Previous literature points to persistence of symptoms, distrust about medications, seeking a second opinion, and family’s and friends’ advice as the most common reasons for doctor shopping [6]. Such behavior reflects that the needs of patients are not being sufficiently addressed [13]. …”