Jaafer N1, Biernikiewicz M2, Toumi M3
1Creativ-Ceutical, Tunis, Tunisia, 2Creativ-Ceutical, Cracow, Poland, 3Aix-Marseille University, Marseille, France
OBJECTIVES: Doctor-shopping entails visiting multiple physicians with the same complaint and is associated with a number of factors, including a poor patient-physician relationship. This study aimed to review the literature regarding physician characteristics that might contribute to doctor-shopping. METHODS: A systematic literature review was performed in PubMed and supplemented by a Google search, using the term ‘doctor-shopping’. Other terms, including ‘physician’s experience’, ‘prescribers’, and ‘drug prescription’, were also used. Overall, 2885 records were identified, out of which 13 were analysed. RESULTS: The prevalence of doctor-shopping varied and in some cases was high, ranging from 0.5% among American opioid users to 25% among general practitioner patients in Japan. Reports on prescriber characteristics and on experiences related to doctor-shopping were scarce. Studies focussed mainly on prescribers’ use of prescription drug monitoring programmes and analyses of filled prescriptions in prescription monitoring databases. Physicians visited by doctor-shoppers were mainly men older than 50 years of age, and were mainly general practitioners, emergency department physicians, and psychiatrists who prescribe opioids. When physicians identified doctor-shoppers, their emotional responses included feeling overwhelmed, disheartened, discouraged, and resentful, which usually resulted in their ending the patient-physician relationship. Physician-specific factors that contributed to doctor-shopping included long waiting times in Hong Kong; physician attitude perceived as stringent, stern, or strict among French patients; inconvenient office hours or locations; undesirable personal qualities of the physician; and insufficient time for communication between clinician and patient in the US. CONCLUSIONS: Physician experiences with and responses to doctor-shopping have a bearing on the quality of health care. Further research is needed to elucidate the characteristics of physicians who are at risk of being visited by doctor-shoppers, to increase awareness among health care providers and educate physicians on how to recognise doctor-shoppers. This may help prevent the negative consequences of this phenomenon.
Conference/Value in Health Info
2018-11, ISPOR Europe 2018, Barcelona, Spain
Value in Health, Vol. 21, S3 (October 2018)
Health Service Delivery & Process of Care