What Is Doctor Shopping?
Healthcare has always centered around the circular nature of the doctor-patient relationship. The patient’s primary goal of seeing a doctor is to receive care for whatever medical concerns they may have, and, in turn, the goal of the medical provider is to provide appropriate diagnostics and treatment.
This relationship has changed over the years due to the discovery and implementation of medications with physical dependency risks, further adding complexity to the substance use epidemic.
This change has spurred a trend known as “Doctor Shopping”, where individuals seek out multiple medical providers, generally during an episode of illness, to obtain controlled substances for purposes that do not follow medical guidance. Prescriptions for controlled substances are often restricted to specific doses, amounts, and refills which can feel limiting for someone who is misusing the substance, leading to the start of these behaviors.
Doctor shopping is often considered a serious sign that an individual has developed a substance use disorder. When doctor shopping, an individual makes multiple appointments to see different prescribing physicians to obtain a controlled substance, such as an Opioid. They do not share that they are seeing other medical providers to maximize the number of prescriptions they receive.
Doctor shopping has become such a significant concern that it is considered an illegal activity in the US, with each state having its own laws meant to deter individuals from deceiving medical professionals. Unfortunately, doctor shopping can lead to serious consequences such as controlled substances being provided in larger amounts than medically necessary and substance misuse.
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Reasons People Doctor Shop
It’s important to note that doctor shopping is not the same as seeking out a second opinion. If the intention is to take advantage of the healthcare system and acquire drugs by seeing multiple doctors, it is doctor shopping. Acceptable reasons to see multiple doctors include:
- Disagreeing with a particular diagnosis and wanting a second opinion.
- Feeling a lack of improvement from prior appointments.
- Trying to find a doctor that you have good rapport with and feel comfortable with.
- Trying to find a doctor who can provide long-term care.
While these are acceptable reasons to doctor shop, concern arises when the individual intends to manipulate the provider for a certain outcome.
Many individuals who engage in doctor shopping are often experiencing some form of psychological or physical distress related to the conditions they are experiencing. This could look like someone who struggles with chronic pain and has not found a provider who can “help” resolve their pain.
It can also include when individuals see medical providers who are not able to find a medical reason for their discomfort, prompting a cycle of seeking a provider who will “cure” their ailment. These situations can be difficult, as they are often associated with increased emotional discomfort including anxiety and depressive symptoms. These conditions can lead to misusing substances to manage their physical and emotional discomfort.
The most common substances that individuals seek when doctor shopping are Opioids (often Percocet or OxyContin), though other medications such as Benzodiazepines (often Xanax or Klonopin) are routinely requested as well.
Unfortunately, even an appropriate prescription for an Opioid to assist with pain relief can result in long-term physical dependency when there is no strategy to find a solution to the pain.
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Signs Of Doctor Shopping
If you or someone you care for may be doctor shopping, there are a few common high-risk behaviors to watch for.
- Having multiple appointments with different medical providers in a short period, often without specific medical needs.
- Frequent complaints about their medical provider being unwilling to provide a certain prescription and planning to find other providers who will.
- Making appointments with medical providers in multiple locations, such as different counties or states, to conceal their appointments and prescriptions.
- Having several prescriptions for the same medication from multiple medical providers within short periods.
- Having amassed many prescriptions from providers over the years for the same medication.
- Frequently “losing” or “dropping” medication down the drain, requiring more frequent emergency refills than would be reasonably expected.
- Overusing and running out of medications, resulting in panic to get refills.
If any of these behaviors appear familiar to a loved one or yourself, there is a strong chance that there is a substance misuse condition developing that will not resolve on its own without professional support.
There are serious risks associated with substance misuse that can develop in severity in a very short period. Behaviors such as doctor shopping can create situations where large amounts of controlled substances, such as Opioids or Benzodiazepines, can be obtained. This can frequently result in overuse of the medication and increase the possibility of experiencing an overdose event or potential loss of life.
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As doctor shopping becomes more pervasive in the healthcare industry, there has been more focus on proactively identifying individuals who are engaged in the process and attempting to treat them more effectively.
Some states have developed interdisciplinary databases of prescriptions for controlled substances that have provided evidence-based benefits in reductions in overdoses related to Opioids. This has assisted medical prescribers and pharmacists with a way of ensuring no inappropriate prescription lapses or overfills are being provided, however, this is not a foolproof system or utilized in every state.
If you or a loved one participate in doctor shopping to obtain controlled substances, you may benefit from learning more about potential treatment programs.
Ashish Bhatt, MD, MRO
Doctor of Addiction Medicine
Learn about Dr. Ashish Bhatt
Dr. Bhatt has been Addiction Center's Medical Content Director for more than three years, providing his expertise to ensure quality and accuracy.
Doctor of Addiction Medicine
Expert in adult and child psychiatry
Over 20 years of professional experience