In recent months there have been articles claiming a number of patients are “doctor-shopping” for prescription pain pills. This is a major problem for the vast majority of people with chronic illnesses, because drug dealers make appointments as chronic pain sufferers in hopes of collecting scripts for street sales. Laws have strengthened over the years for the alleged war on drugs, but this has put a hardship on doctor-patient relationships. Doctor-shopping injures care for all patients, and for many reasons.
More times than not, a person can ask one question in any chronic pain forum: Has anyone been dismissed by a doctor for their pain? Depending on the size of the group, there could be hundreds or even thousands of people responding, yes. For whatever reason, patients are discriminated against if they ask for pain medication—women especially.
An author for HealthDay by the name of Dennis Thompson claims one in every 50 prescriptions of narcotics or addictive drugs are filled by “doctor shoppers.” There is a study by Douglas McDonald that found this statistic to be significant, but doctor shoppers allegedly only make up 1 percent of all patients purchasing painkillers in 2008.
Trisha Torrey, a writer on patient empowerment, describes many forms of patient discrimination. When a male doctor tells a female patient, “it is all in your head,” that is discrimination.
When medical studies were conducted with male subjects, and then translated to women afterwards, that is discrimination. Torrey claims what most medical practitioners know about medicine is based on old studies of white males.
One large, under-reported issue that injures patient-care worldwide does not involve doctor-shopping at all. Often, when women are given prescription pain killers, they are not strong enough or large enough in quantity. Studies could function to understand how doctors decide to give male patients stronger prescriptions than female patients, even if the female patient reports more serious symptoms.
Another form of discrimination, however, is when a man feels a lump in his chest and the doctor, male or female, says, “Don’t worry about it,” that is also discrimination because 2,000 men, roughly, are diagnosed with breast cancer each year.
If a woman does not present with chest pains, despite weakness in her arms and symptoms of indigestion, but is then told by the MD that it is nothing, that too is also discrimination, because only 50 percent of women who have a heart attack suffer chest pain. Signs of a female heart attack are present, but overlooked.
It is not unheard of for women to expect a cynical perspective from her doctor after reporting distressing symptoms; in fact, there are guides available to women with chronic pain for use when communicating with a doctor. There would be no guides if doctors were held to a higher standard; they continue to provide less than adequate care when basing opinion on prejudice.
One guide comes from womenshealth.gov. In this manual, women are said to be typically viewed by doctors to overstate symptoms and then are less likely to receive painkillers. Women are also more likely to have chronic pain. Dr. Clair Francomano, head of adult genetics program at the Greater Boston Medical Center, claims a man’s build is often more protective, muscular-wise, and so men face less risk of chronic pain syndromes like connective tissue disease.
So with all the reports demonizing patients searching for medical relief, there exists a hardship on everyone suffering from, or who will suffer from, chronic pain. The Drug Enforcement Administration’s war on drugs puts much stress on doctors, in turn, making it exceedingly difficult for women who were already disproportionately discriminated against to obtain proper treatment.
Doctor-shopping injures the care for all who are in need of obtaining pharmaceuticals, but future studies could bring to light the degree to which some patients are unfairly treated statistically, which can in turn elicit efforts to reduce disparities.
Opinion By Lindsey Alexander
Dr. Francomano Presentation 2013