Be Wary of ‘Prescription Inflation’ When Treating New Patients

Patients who read (or, maybe more likely, see an online or television commercial) about “new” disorders whose descriptions may apply to them could be inclined to run off to the urgent care center for immediate evaluation, even if there’s nothing urgent about their condition. Diagnoses that didn’t even exist or were seldom made a decade ago (eg, adult ADHD, low testosterone) are now being described in breathless detail. Even recognized disease states like diabetes continue to be redefined by virtue of thresholds that keep getting lower. The bottom line: New definitions and diagnostic criteria ensure that millions of people suddenly believe they have a treatable disorder. The most anxious of those patients may be inclined to seek immediate care. Urgent care providers should be wary of making new diagnoses in such patients. At the same time, respectful attention must be paid to people who are sincerely concerned, even if those concerns are inflated. The best course of action may be to listen, assess the patient per the presenting complaint, and refer them to their primary care provider or a specialist. One caveat: Symptoms that a patient attributes to a disorder they just read about could be indicative of an unrelated condition, so keep an open minded when evaluating even patients who seem like hypochondriacs.