Doctor shopping

Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
Founder, WikiMD Wellnesspedia &
W8MD medical weight loss NYC and sleep center NYC
Doctor shopping, also referred to as double doctoring, is the act wherein patients solicit care from multiple healthcare providers, often concurrently, without seeking to integrate care or notify these providers of the multiple consultations. This behavior often emerges from an individual's dependence on, or addiction to, specific prescription medications. Though the primary intention behind this act often relates to addiction, it also arises from various other motivations, including the perception of certain prescription drugs as recreational substances or even for potential economic gain through the resale of such drugs.

Reasons for Doctor Shopping

Addiction and Dependence

Many individuals resort to doctor shopping as a means to sustain their addiction or reliance on particular prescription drugs. This typically commences when a patient, after being legitimately prescribed a drug for a genuine medical condition, then seeks out additional physicians to acquire more of the same medication. This is often facilitated by deceptive practices like exaggerating or feigning medical symptoms.

Prescription Limitations

In the U.S., due to increased oversight of prescription practices and the prosecution of doctors for purported over-prescription of certain drugs like opiate analgesics and benzodiazepine tranquilizers, several physicians have grown hesitant to offer extensive doses or renew prescriptions for these drugs. This, even when there's a genuine medical requirement, has inadvertently forced some patients into doctor shopping to meet their legitimate medical needs.

Distinguishing Dependency from Addiction

For healthcare providers, distinguishing genuine medical needs from drug-seeking behaviors can be complex. It's crucial to differentiate between:

• Tolerance: When a drug doesn't provide the same effect as it initially did.
• Dependence: When the body's neurons adapt and function normally only in the drug's presence.
• Addiction: A chronic relapsing disease characterized by compulsive drug-seeking behaviors.

Prescription Drugs Commonly Sought

Doctor shopping is often associated with drugs that have high potential for addiction or dependence.

Sedatives

Drugs such as zolpidem (Ambien), alprazolam (Xanax), and diazepam (Valium) are often dispensed in limited quantities due to their addiction potential. Patients may become reliant on these to manage sleep disorders or anxiety.

Opiate and Opioid Painkillers

Medications like oxycodone (e.g., Percocet, OxyContin), hydrocodone (e.g., Vicodin, Lortab), and morphine (e.g., MS Contin) have high addiction potentials. Some less potent opiates and opioids are generally perceived as less addictive, but even these, including tramadol, have risks.

Other Analgesics

Emerging medications include various forms of the powerful narcotic analgesic fentanyl. Stringent regulations often govern these drugs due to their potential for abuse.

Legal Implications

The rampant misuse of prescription medications has garnered attention globally. To counteract the prevalence of doctor shopping:

Regulatory agencies actively discourage doctor shopping by tightening oversight processes. Some U.S. states have criminalized doctor shopping. Physicians receive education and training on the risks of over-prescription.

Summary

Doctor shopping remains a significant concern within the healthcare industry, reflecting broader issues related to prescription drug addiction, over-prescription, and the challenges healthcare providers face in discerning genuine medical needs from drug-seeking behaviors. Awareness, combined with improved regulatory oversight and physician training, is essential to address this challenge effectively.

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