Consultation behaviour of doctor‐shopping patients and factors that reduce shopping

Ohira, Yoshiyuki; Ikusaka, Masatomi; Noda, Kazutaka; Tsukamoto, Tomoko; Takada, Toshihiko; Miyahara, Masahito; Funakoshi, Hiraku; Basugi, Ayako; Keira, Katsunori; Uehara, Takanori

doi:10.1111/j.1365-2753.2010.01605.x

Cited by 23 publications

(22 citation statements)

References 7 publications

(8 reference statements)

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“…In studies enrolling patients with chronic conditions such as diabetes [7], eye floaters [26], or nephrolithiasis [9], the definition of doctor-shopping specified a higher number of visits, whereas in cases of urgent conditions or infections, definitions specified a timeframe and were, for example, limited to one day [27] or to the same illness episode [6,10,12,[28][29][30][31][32][33][34]. Studies focusing on the evaluation of doctor-shopping in general medicine or primary doctor facilities had longer timeframes of 1 year [35,36], 2 years [37], or even 3 years [38].…”

Section: Definition Of Doctor-shoppingmentioning

confidence: 99%

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Characteristics of doctor-shoppers: a systematic literature review

Biernikiewicz¹,

Taieb²,

Toumi

2019

Journal of Market Access & Health Policy

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Objective: Doctor-shopping has significant consequences for patients and payers and can indicate misuse of drugs, polypharmacy, less continuity of care, and increased medical expenses. This study reviewed the literature describing doctor-shoppers in the adult population. Methods: A systematic literature review was performed in PubMed and supplemented by a Google search of grey literature. Overall, 2885 records were identified; 43 papers served as a source of definition of a doctor-shopper, disease, treatment, patient characteristics, patient special needs, country. Results: Definitions of doctor-shopping were heterogeneous. Overall, 40% of studies examined the use of opioids, antidepressants, or psychoactive drugs, while the others focused on chronic or frequent diseases. Most studies were conducted in countries with easy access to healthcare resources (USA, France, Taiwan, Hong Kong). The prevalence of doctor-shopping ranged from 0.5% among opioid users in the USA to 25% of patients registered at general practices in Japan. Comorbidities, active substance abuse, greater distance from healthcare facility, younger age, longer disease and poor patient satisfaction increased doctor-shopping. Conclusions: Knowing the characteristics of doctor-shoppers may help identify such patients and reduce the associated waste of medical resources, but concerns about the misuse of drugs or healthcare resources should not prevent proper disease management.

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Section: Definition Of Doctor-shoppingmentioning

confidence: 99%

“…Patients visit more doctors when they have a chronic disease or a drug addiction and their health problem remains unresolved despite receiving treatment [9][10][11]. Among factors that reduce doctor-shopping are a proper diagnosis, high patient satisfaction and a good patient-doctor relationship [12,13].…”

Section: Introductionmentioning

confidence: 99%

Characteristics of doctor-shoppers: a systematic literature review

Biernikiewicz¹,

Taieb²,

Toumi

2019

Journal of Market Access & Health Policy

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“…These experiences were perceived as mismatch, which contributed to participants’ doctor shopping behavior. In contrast, patient satisfaction significantly discourages doctor shopping behavior [35]. Unfortunately, miscommunication between patients and doctors is common [22,23]; this is particularly true for OAB patients [24], and patients with OAB are commonly dissatisfied with the care they receive [23].…”

Section: Discussionmentioning

confidence: 99%

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

Siu

2014

BMC Fam Pract

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BackgroundAlthough having a regular primary care provider is noted to be beneficial to health, doctor shopping has been documented as a common treatment seeking behavior among chronically ill patients in different countries. However, little research has been conducted into the reasons behind doctor shopping behavior among patients with overactive bladder, and even less into how this behavior relates to these patients’ illness and social experiences, perceptions, and cultural practices. Therefore, this study examines overactive bladder patients to investigate the reasons behind doctor shopping behavior.MethodsMy study takes a qualitative approach, conducting 30 semi-structured individual interviews, with 30 overactive bladder patients in Hong Kong.ResultsMy study found six primary themes that influenced doctor shopping behavior: lack of perceived need, convenience, work-provided medical insurance, unpleasant experiences with doctors, searching for a match doctor, and switching between biomedicine and traditional Chinese medicine. Besides the perceptual factors, participants’ social environment, illness experiences, personal cultural preference, and cultural beliefs also intertwined to generate their doctor shopping behavior. Due to the low perceived need for a regular personal primary care physician, environmental factors such as time, locational convenience, and work-provided medical insurance became decisive in doctor shopping behavior. Patients’ unpleasant illness experiences, stemming from a lack of understanding among many primary care doctors about overactive bladder, contributed to participants’ sense of mismatch with these doctors, which induced them to shop for another doctor.ConclusionsOveractive bladder is a chronic bladder condition with very limited treatment outcome. Although patients with overactive bladder often require specialty urology treatment, it is usually beneficial for the patients to receive continuous, coordinated, comprehensive, and patient-centered support from their primary care providers. Primary care doctors’ understanding on patients with overactive bladder with empathetic attitudes is important to reduce the motivations of doctor shopping behavior among these patients.

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“…Given that switching triggers tend to be industry and sector specific, as noted above, our exploration should improve understanding of the switching phenomenon and could lead to further refinement of the switching model. Furthermore, this switching model of Figure 1 assimilated disparate switching triggers found in the health services literature (from example, Gandhi et al, 1997;Asmah et al, 2005;Ohira et al, 2012;Shin et al, 2012;Afolabi et al, 2013) into a comprehensive framework for back pain sufferers using complementary and alternative medicine, for the first time. Later research can build on the findings of this research by including other elements of Roos et al's (2004) and Roos and Friman's (2008) frameworks.…”

Section: Research Issue 2: Emotions and Switchingmentioning

confidence: 94%

“…We used the three categories of switching triggers developed by Roos et al (2004) as a starting point for this research and assigned switching factors found by other researchers to these categories into Figure 1 (e.g. Asmah et al, 2005;Beest et al, 2012;Gandhi et al, 1997;Nakamura et al, 2011;Ohira et al, 2012;Shin et al, 2012). Note that the categories of triggers identified by Roos et al (2004) and applied in this paper comprise only a subset of their overall conceptual framework for switching in later research (Roos and Friman, 2008).…”

Section: Research Issue 2: Emotions and Switchingmentioning

confidence: 99%

Factors influencing back pain treatment behaviour change

McClymont

Gow

Hume

et al. 2015

Journal of Service Theory and Practice

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Purpose -The authors seek to better understand the critical incidents and factors that influence the switching behaviours of back pain sufferers who use mainstream and/or complementary and alternative medicine (Edvardsson, 1998). That is, the purpose of this paper is to uncover how they switch between treatments and treatment providers; in particular, this research investigates two issues: the triggers of their switching and their switching paths, and how their emotions are involved in that switching. The contribution is the first empirical foundation for an understanding of these two issues in the context of back pain. Design/methodology/approach -The qualitative technique of convergent interviewing was used. It involved conducting a series of long, initially rather unstructured interviews to converge on the important topic areas to the back pain sufferers and why they engage in their treatment behaviour. Findings -This study investigated the triggers and categories of triggers that impact upon switching behaviours between bio-medical and CAT healthcare. Four main areas of findings were identified. First, although the literature identified four categories of triggers for switching, namely, situational, reactional, influential and personal characteristics, the findings of this research confirmed only two of these: reactional and situational triggers. The influential category of triggers was found to be more of a moderating factor between switching triggers and switching behaviours rather than a trigger factor on its own. Further, no evidence came to light that could confirm or disconfirm the roles of personal characteristics on switching behaviour and so this issue remains unresolved.Research limitations/implications -The methodology used in this research was an exploratory one and so the findings must be used with caution. Further research, using a more quantitative methodology, is warranted to confirm the findings of this research. Also, this research focused on a subset of switching issues and so might not provide a holistic framework. Future investigations should therefore consider and clarify the role of emotion, time and voice in the switching model devised from this study. Originality/value -This paper provides new evidence on the reasons for back pain sufferers consuming different treatment modes and the reasons for their switching and includes an exploratory investigation of the role of emotions in this decision making.

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Consultation behaviour of doctor‐shopping patients and factors that reduce shopping

Abstract: Doctor shopping decreased significantly after patients consulted our department, with 'confirmation of the diagnosis' and 'satisfaction with consultation' being identified as contributing factors.

Cited by 23 publications

References 7 publications

Characteristics of doctor-shoppers: a systematic literature review

Characteristics of doctor-shoppers: a systematic literature review

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

Factors influencing back pain treatment behaviour change

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