Avoiding the doctor’s office? You are not alone.
As a primary care physician, an important part of my job is to ensure patients are up-to-date on their “health maintenance,” which includes screening tests (e.g. pap smears or colonoscopies) and also preventive medicine (e.g. flu shots). I spend hours talking with patients about the importance of health maintenance, inquiring about any barriers to getting care, and helping them brainstorm solutions to overcome these barriers. I truly believe in the importance of these things, and it is one of the reasons that I chose family medicine.
Ironically, though, when I look at my own medical chart, my “health maintenance” tab is filled with red “overdue” items. I recently began to reflect on this issue to try to better understand the factors that are causing me to avoid seeking care, with the hope that better understanding my concerns will help me overcome them.
As a researcher, I naturally decided to look at what has been published about this issue, and I was reassured to learn that I am not alone. Nearly one-third of Americans have avoided going to the doctor at some point. Researchers have identified several factors that lead to avoidance of the doctor. Not surprisingly, time constraints are a common concern, and as a busy resident physician this can certainly be an issue for me.
But even if I had all the time in the world, it might still be hard for me to get to the doctor, due to what researchers have termed “affective concerns.” What does this mean? Essentially, this means that I (a doctor) have negative emotions and fears associated with going to the doctor!
Since this directly impacts my health and well-being, I decided that it deserved my attention. After much reflection, I determined that my main concerns are fear of judgment and discomfort with vulnerability, which are exaggerated in a health care system that often lacks continuity with one specific provider. In particular, I worry about whether health care professionals may treat me differently or judge me if they learn that I previously dealt with depression and an eating disorder.
But I must ask myself: Are these fears well-founded? Furthermore, even if they are well-founded, should I let them drive my behavior? My fears do reflect actual past negative experiences at doctors’ offices, but they are also projections driven by irrational fears and my own insecurities.
I’m happy to report that I have decided to “dare greatly” and schedule an appointment to check off those red “overdue” items on my health maintenance list. The fears are still there, but I am choosing to act in spite of them. My own experiences have shaped the type of physician I strive to be – one who is supportive, non-judgmental, and practices whole-person care. I’m grateful to be part of a residency program that embraces these values as a core part of our training and allows space for self-reflection and personal growth.
Karen Scherr, M.D., Ph.D., is chief resident of the Duke Family Medicine Residency Program. Email karen.scherr@duke.edu with questions.
Editor’s note: Duke Family Medicine residents guest blog every month. Blogs represent the opinion of the author, not the Duke Family Medicine Residency Program, the Department of Family Medicine and Community Health, or Duke University.