What is Doctor Shopping?
Doctor shopping refers to the illegal practice of a patient visiting multiple physicians and pharmacies to obtain multiple prescriptions for controlled substances, like opioids, without disclosing this activity to the healthcare providers. The central deceit lies in concealing a "material fact"—the existence of other concurrent prescriptions for the same or similar medications. It is distinct from seeking a second, legitimate medical opinion from another physician. This behavior is most often associated with prescription drug addiction, although it can be driven by other motivations, including the intent to sell the drugs for financial gain.
The Motivations Behind Doctor Shopping
Several underlying issues can drive a person to engage in doctor shopping. Understanding these motivations is crucial for addressing the problem effectively. Some of the most common reasons include:
- Prescription drug dependency: As a person's tolerance to a medication like an opioid or benzodiazepine grows, they may need larger or more frequent doses to achieve the desired effect. This can lead them to seek prescriptions from multiple doctors when their primary physician refuses to increase the dosage.
- Undertreated chronic pain: Some patients with chronic pain may feel their condition is not being adequately managed by their current doctor. Rather than having an open discussion with their primary care provider, they may turn to other physicians to get more or stronger pain medication.
- Mental health struggles: Individuals struggling with conditions like anxiety or depression may misuse medications to cope with their symptoms. This can lead to a cycle of seeking multiple prescriptions to maintain their self-medication habit.
- Prescription drug diversion: In some cases, people obtain multiple prescriptions not for their own use, but to sell the controlled substances for profit on the black market. This poses a serious public health threat by fueling the illegal drug trade.
Common Tactics Used by Doctor Shoppers
Individuals who engage in doctor shopping often use manipulative and deceptive behaviors to get what they want. They know the healthcare system and try to exploit loopholes to avoid detection. Common tactics include:
- Feigning or exaggerating symptoms: A patient may fabricate or exaggerate symptoms to convince a doctor that they require a controlled substance prescription.
- Falsifying prescription history: They may provide false information about their medical history or deny having received similar prescriptions from other doctors.
- Claiming lost or stolen prescriptions: This is a common excuse for requesting early refills. When a patient repeatedly claims to have lost or had their medication stolen, it is a significant red flag.
- Paying with cash: Using cash to pay for doctor visits and prescriptions helps patients avoid creating insurance records that could link their visits to multiple providers.
- Visiting multiple emergency rooms: Patients sometimes visit different hospital emergency rooms, especially in different cities, to obtain prescriptions for pain medication, knowing that ER doctors may not have immediate access to their full medical history.
The Serious Risks and Consequences
Doctor shopping is a dangerous and illegal practice with severe consequences for both the individual and public health.
Health Risks
For the individual, the health risks are significant and potentially fatal:
- Overdose: The most dangerous risk is an accidental overdose, which can occur from taking excessive amounts of a substance or combining multiple prescriptions without a single doctor's knowledge.
- Drug interactions: When multiple controlled substances are prescribed by different doctors, there is a high risk of dangerous and unmonitored drug interactions.
- Undiagnosed conditions: A doctor shopper's underlying health issues may go undiagnosed or untreated as they focus solely on obtaining a specific medication, potentially worsening their overall health.
- Addiction: The behavior is often a symptom of or a path toward a serious substance use disorder, requiring professional treatment to overcome.
Legal Penalties
Doctor shopping is a crime in all 50 states and at the federal level, often prosecuted as prescription fraud. The legal consequences can include:
- Fines: Significant financial penalties can be imposed upon conviction.
- Incarceration: Sentences can range from county jail time for a misdemeanor conviction to several years in prison for a felony.
- Probation and treatment: For some first-time offenders, courts may offer diversion programs that allow for addiction treatment instead of jail time.
How Healthcare Systems Combat Doctor Shopping
To counter this dangerous practice, healthcare systems and government agencies have implemented several strategies.
Prescription Drug Monitoring Programs (PDMPs)
Electronic databases known as PDMPs are now a key tool in detecting and preventing doctor shopping. These programs collect and analyze data on controlled substance prescriptions dispensed within a state. When a doctor or pharmacist checks the PDMP, they can see a patient's prescription history, revealing if they have received prescriptions from multiple providers recently. All 50 states have either a mandatory or voluntary PDMP in place.
Electronic Prescribing (e-Prescribing)
Using electronic prescribing systems reduces the risk of prescription fraud by eliminating paper scripts that can be easily forged or altered. E-prescribing also makes it easier for healthcare providers to access and monitor a patient's medication history.
Doctor Shopping vs. Legitimate Second Opinion
It is important to distinguish doctor shopping from the legitimate practice of seeking a second medical opinion. The key difference lies in the patient's intent and transparency.
| Feature | Doctor Shopping | Seeking a Second Opinion |
|---|---|---|
| Intent | Obtain excess medication through deceit | Gain more information or explore alternative treatments from another expert |
| Transparency | Withholds information about other prescriptions | Provides full medical history and discloses all current medications |
| Primary Goal | Secure more of a controlled substance | Ensure the initial diagnosis and treatment plan are correct and optimal |
| Ethicality | Unethical and illegal | Standard and ethical healthcare practice |
The Role of Healthcare Providers and Patients
Patients who are struggling with addiction or chronic pain should be upfront and honest with their healthcare providers. If a treatment plan is not working, the best course of action is to discuss concerns openly with the doctor, rather than seeking additional prescriptions from other sources. There are many legitimate alternatives, such as pain management specialists or addiction treatment programs, that can provide safe and effective care. Healthcare providers also have a responsibility to look for red flags, utilize PDMPs, and communicate with other providers when a patient's behavior raises suspicion.
Conclusion
Doctor shopping is a dangerous and illegal activity driven by various factors, most notably addiction. Its consequences include severe health risks, like overdose, and serious legal penalties. However, with the implementation of tools like Prescription Drug Monitoring Programs (PDMPs) and increased awareness, healthcare providers are better equipped to detect and prevent this deceptive practice. Patients struggling with addiction or pain should seek legitimate, comprehensive treatment and be transparent with their doctors to ensure their safety and well-being. For more information on prescription drug abuse, visit the CDC's website for resources on prevention and data analysis.
Get help for addiction
If you or someone you know is struggling with substance abuse related to doctor shopping, resources are available. Help can be found through addiction treatment centers, and many state courts offer diversion programs that prioritize treatment over jail time for first-time offenders.
Key Takeaways
- Definition: What does doctor shopping mean? It's the illegal act of acquiring controlled substances from multiple doctors without revealing the other prescriptions.
- Primary Motivation: The main driver for doctor shopping is often substance dependency or addiction to prescription drugs like opioids or benzodiazepines.
- Serious Risks: Health risks include accidental overdose and dangerous drug interactions due to uncoordinated prescriptions.
- Illegal Consequences: Doctor shopping is a crime in all states, often charged as prescription fraud, which can lead to felony convictions, fines, and jail time.
- Detection: Prescription Drug Monitoring Programs (PDMPs) are a primary tool used by pharmacists and doctors to detect patient prescription patterns and prevent fraud.
- Prevention: Being honest with one primary healthcare provider and seeking legitimate pain management or addiction treatment are crucial alternatives to this dangerous practice.
FAQs
Q: What is the difference between doctor shopping and getting a second opinion? A: The key difference is intent and transparency. Seeking a second opinion is a legitimate practice where a patient is transparent with all doctors, whereas doctor shopping involves deceit to obtain excessive medication.
Q: How do doctors and pharmacists detect doctor shopping? A: They primarily use Prescription Drug Monitoring Programs (PDMPs), which are state-wide databases that track controlled substance prescriptions. These programs flag suspicious patterns, such as multiple prescriptions from different doctors.
Q: Is doctor shopping always a felony offense? A: No. Depending on state laws and the specifics of the case, it can be charged as either a misdemeanor or a felony. Repeat offenses or intent to sell usually result in more serious felony charges.
Q: What happens if you get caught doctor shopping? A: Consequences vary but can include fines, imprisonment, and mandatory substance abuse treatment. Some jurisdictions offer diversion programs for first-time offenders.
Q: What are the warning signs of doctor shopping in a loved one? A: Warning signs include frequent claims of lost or stolen prescriptions, paying cash for medications despite having insurance, and requesting early refills.
Q: What kinds of medications are most often involved in doctor shopping? A: Controlled substances, including opioid painkillers (like oxycodone, hydrocodone), benzodiazepines (like Xanax, Valium), and stimulants (like Adderall), are most commonly targeted.
Q: Can electronic prescribing help stop doctor shopping? A: Yes. E-prescribing reduces the risk of forged or altered paper prescriptions and provides a digital trail that is harder for a patient to manipulate.
