From NPR: How The Modern Patient Drives Up Health Costs

by Alix Spiegel

The doors to the clinic had been locked for over an hour, and the last light in the sky was quickly fading when two eyes appeared in Teresa Moore’s office window, followed by a sharp knock and a glass-muffled plea to be let in: It was a patient.

Moore walked the halls of her closed practice and swung open the heavy front door to a woman in her 30s, who staggered forward muttering, “Sorry.” The woman was a regular — someone with migraines — so even though it was after hours and Moore had two children waiting at home, she waved her in.

Moore’s family practice is in Keysville Va., the same small community where she grew up. Her patients are people who attended her baptism and helped at her wedding. So in some ways, Moore has a true old-timey medical practice. But in one important way, her practice is completely different:

Moore cares for modern patients. They’re the people who come in with specific requests for medications and procedures. And oftentimes they get what they ask for, whether they need it or not. This consumer-driven health care is part of what’s driving up costs across the country.

The Modern Patient

The patients come in quoting commercials they’ve seen on TV, requesting pills or diagnostic tests, describing new treatments for diseases they’re convinced they have.

“Five or six times a day, people come in saying, ‘I looked this up on the Internet.’ Or, ‘I saw this and I wonder if I could have this?’ ” Moore says.

Sometimes her patients are right; more often they’re wrong, she says. But Moore isn’t judgmental about their self-diagnoses. She views it as a natural response to the ocean of health information that surrounds every modern person, and relates it to her own experience in medical school.

“There’s a syndrome in medical school they teach us about called ‘medical student syndrome,’ ” Moore says. When medical students learn about a disease for the first time, it’s common for them to become convinced, at least temporarily, that they themselves are afflicted.

“Every time you start reading about this disease, you say, ‘Oh my god, I have that!’ Then you read about another disease and you say, ‘Oh my god, I have that, too!’ ” Moore says. “So, the same thing that triggers medical students to worry that they have these diseases is part of what triggers people watching television or surfing the Internet to believe they have these conditions. Continued re-exposure to suggestions of symptoms makes people look for things.”

The problem, says Moore, is that it can take a lot of work to convince her patients that their own diagnosis is wrong. More accurately, it takes a lot of work with her younger patients.

“In the older population, there is a tremendously different dynamic,” Moore says. “There’s a lot more belief and trust in doctors.” But not in younger patients. “In patients between 25 and 50,” she says, “there is a lot more push to get what they want.”

What Transformed Patient Behavior…read entire post here: http://www.npr.org/templates/story/story.php?storyId=113664923