Doctor shopping

Doctor shopping is the practice of visiting multiple physicians to obtain multiple prescriptions for otherwise illegal drugs, or the medical opinion that one wants to hear. It is a common practice of drug addicts, suppliers of drug addicts,[1] hypochondriacs[2][3] or patients of factitious disorder and factitious disorder imposed on another.[4][5] A doctor who, for a price, will write prescriptions without the formality of a medical exam or diagnosis is known as a "writer" or "writing doctor".[6]

Description

A doctor shopper will visit multiple health care providers as a "new patient" or "visiting from out of town," and will exaggerate or feign medical problems to obtain prescriptive medications[7] or a wanted medical opinion, diagnosis or treatment with no specific material gain.[2][3][4][5]

For prescription drugs

Frequently involved in prescription fraud are narcotics, stimulants, barbiturates, benzodiazepines, tranquilizers and other psychoactive substances manufactured for use in legitimate medical treatment. Law enforcement officers spend a significant amount of time investigating cases involving prescription fraud, many of which also involve insurance, Medicare, or Medicaid fraud.[7]

Prescription drug diversion occurs by faking, forging, or altering a prescription; obtaining bogus prescriptions from criminal medical practitioners; or buying drugs diverted from health care facilities by personnel. Pharmacy thefts are increasing throughout the United States to feed the growing demand for prescription drugs. The rising cost of prescription drugs has also enticed senior citizens to join in the diversion and to sell their prescriptions.[7]

Doctor shopping is a kind of malingering with the specific goal of procuring prescription drugs. Malingering is underdiagnosed, often because of the physician's fear of making false accusations. Covert surveillance has indicated that as many as 20% of pain clinic patients misrepresent the extent of their disability. The judgment of the morality of malingering is largely a matter of the observer and circumstances. Most people would regard the defraudment of an insurance company, by a false injury, as an antisocial act. In contrast, the malingering of a prisoner-of-war, who is attempting to manipulate his or her captors, would be seen by most compatriots as a skillful coping mechanism.[8]

Doctor shopping is associated with the ubiquitous medicalization of drug use, as an alternative to criminalization and legalization.

In hypochondriasis and factitious disorders

Some patients of hypochondria, factitious disorder and factitious disorder imposed on another will visit multiple health care providers to find a medical opinion, diagnosis or treatment that they feel the need to get,[2][3][4][5] not specifically in search of prescription drugs, for no material benefit[9][10] and even incurring in significant costs, debts or losses. This kind of doctor shopping lacks intention to commit malingering for material gain and is the result of such mental conditions.

See also
  • Diploma mill
  • Forum shopping
  • Magistrate shopping by the police, to obtain arrest and search warrants from judges who would give only minimal scrutiny to the application

References
  1. Tom Dalzell (2009), The Routledge Dictionary of Modern American Slang and Unconventional English (8th ed.), Routledge, p. 299
  2. "Hypochondriasis (DSM-IV-TR #300.7)" (PDF). Brown University.
  3. Maria Sandra Cely-Serrano, MD. "Pediatric Hypochondriasis Clinical Presentation". Medscape.
  4. Marc D. Feldman, M.D. (2004), Playing Sick? Untangling the Web of Munchausen Syndrome, Munchausen by Proxy, Malingering, and Factitious Disorder, Routledge, pp. 188, 210
  5. Elizabeth M. Varcarolis RN MA; Margaret Jordan Halter PMHCNS (2014), Essentials of Psychiatric Mental Health Nursing: A Communication Approach to Evidence-Based Care (2nd ed.), Elsevier, p. 195
  6. Tom Dalzell (2009), "writing doctor", The Routledge Dictionary of Modern American Slang and Unconventional English, Routledge, pp. 1065–1066, ISBN 978-0-415-37182-7
  7. Kären M. Hess; Christine Hess Orthmann (2010), "Other Challenges to the Criminal Investigator", Criminal Investigation (9th ed.), Delmar, p. 546
  8. Charles V. Ford (2008), "Factitious Disorders and Malingering", in Michael H. Ebert; Peter T. Loosen; Barry Nurcombe; et al. (eds.), Current Diagnosis & Treatment: Psychiatry (2nd ed.), McGraw-Hill, ISBN 978-0-07-142292-5
  9. Dr. Guy E Brannon MD. "Factitious Disorder Imposed on Another - Etiology". Medscape, WebMD. Retrieved 19 June 2016.
  10. "Diseases and conditions - Factitious disorders". Cleveland Clinic. Retrieved 19 June 2016.
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