Polydoc

We, doctors more often than not, are familiar with polypharmacy. That is when a patient is prescribed with multiple drugs for a single diagnosis. Polydoc is when a patient consulted many different doctors for a similar complaint. Polydoc results in polypharmacy. It happens: (i) because of medical subspecialization, (ii) patient mobilization due to frequent movement in term of career and family, (iii) fragmented health care (iv) communication irregularity and (v) side-effects.

Medical subspecialization is good in providing highly specialized care. However, on the flip side, it causes more referral, manpower and resorces. Take for example a diabetic patient with complications: whether he like it or not he has to attend diabetic clinic, eye clinic, neuro clinic and nephro clinic. That may not be considered polydoc as different doctor treat different complications. It is called polydoc when he goes to see different doctor for his numbness and blurring of vision which he thinks may not be related to diabetes.

In this era of modern highways and road connections, a patient may be seeing doctor in JB today and settle down in Kangar the next day. Doctor in Kangar may not communicated with doctor in JB and this practice results in polydoc.

Fragmented health care refers not to system but existing practice in Malaysia when patients go to sinseh, tradisional message, ayurveda and even taking plain air tawar from bomoh. Those people are not doctors but when patients failed their treatment, patients will not go back to their first doctor but will find a new doctor.

Communication irregularity can be the cause and effect of polydoc. Different advices would confuse patients and finally they will find doctor who could give advice suit they own practice not in conformity with what they should do in that particular condition.

Last but not least, is the side-effect of medication. As it used to happen many times, patients who develop side-effect with medication would get advice from different doctors in the context of getting second opinion. This results in polydoc practice.

In conclusion, both doctor and patient must acknowledge this phenomena and realize how it affects the treatment. Both must be honest and find amicable solutions to overcome doctor shopping phenomena.