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Physician Switching After Drug Request Refusal

That is the title from a study from Lee and Bagley (2011). They examine the potential impact of direct to consumer advertising (DTCA) and the impact of physicians decisions not to prescribe a patient-preferred drug on patient retention.

A total of 818 of 2,988 participants in a national telephone survey (27.4%) who had received DTCA reported asking their physician for a prescription drug, and 196 (24.0%) reported that their physician refused to prescribe the drug. Of those whose physicians refused, 13.9% (n = 27 of 194 with data) switched doctors. We found that individuals with regular medical-seeking behavior, full prescription drug coverage, with certain chronic conditions, and of African American origin were significantly more likely to switch physicians in this context.

Are drug refusals largely physicians failing to be patient-centered? Or are drug refusals largely unreasonable patients asking for treatments they don’t need? Your priors likely have a strong influence in how you interpret whether a drug refusal improves or diminishes social welfare.

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