Question 1

Are people with health anxiety more likely to avoid healthcare or use it excessively?

Richard Contrada · Accepted Answer

Health anxiety is more strongly associated with the use of health care than with its avoidance.  Other psychological factors, as well as age, race/ethnicity, and socioeconomic status may moderate (i.e., increase or decrease) the relationship between health anxiety and healthcare use.  But excessive use of healthcare among individuals high in health anxiety is a greater problem than its avoidance.

Question 2

What are the key reasons for avoiding medical care?

Richard Contrada · Accepted Answer

Problems with the affordability and accessibility of healthcare play a major role in this regard.  The uninsured and those with healthcare but who struggle to afford deductibles and co-pays often avoid or delay treatment.  The time, distance, and difficulty entailed in traveling to an appropriate health care facility can also may a major role.   Social and psychological factors, including negative attitudes toward the healthcare system, may be involved as well.  Also at play are beliefs about the efficacy of home remedies and the misinterpretation of symptoms of disease as signs of stress that will be alleviated by rest and relaxation.  And life circumstances, such as job pressures, stressful life events, and caring for friends and family members, can distract attention from one’s own medical issues.

Question 3

Why do you suppose men seek medical assistance less often than women?

Richard Contrada · Accepted Answer

Possible explanations for this phenomenon point to a range of factors.  Some of the difference can be attributed to health conditions involving the female reproductive system and childbirth that require women to use health care and have few if any counterparts in men.  Contributing psychological factors include masculine ideals of toughness and strength that encourage men to minimize signs and symptoms of disease.  Both biological and psychological factors may underlie a tendency for men to be less sensitive than women to changes in physiological functioning.   These and other factors operating at the individual level interact in complex ways with characteristics of the healthcare system.  For example, women’s health care needs require a greater number of specialists than those of men.

Question 4

Has anyone looked interventions or strategies for helping people to be more assertive and advocate for themselves in medical interactions?

Richard Contrada · Accepted Answer

A lot has been said, written, and done about the need for patients to be assertive self-advocates in medical interactions.  A search for the phrase “patient self-advocacy” on the website of a popular bookseller yields 100 hits and there are other terms for this such as “patient empowerment, “patient consumerism.”  This paper reviews recent research and developments on this topic as it pertains to the self-management of chronic disease.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4103232/#:~:text=Emphasizing%20patient%20responsibility%2C%20and%20acting,problems%20associated%20with%20their%20illness.

Question 5

Given iatrogenesis and that medical errors are a leading cause of death maybe people are wise to avoid doctors and the medical system?

Richard Contrada · Accepted Answer

Iatrogenesis and medical errors are major health problems that warrant much more attention than they receive.  But the answer is not to avoid doctors and the medical system.  It is instead to be a well-informed, active self-manager of your medical care, as I have written about here: https://www.psychologytoday.com/us/blog/rabble-rouser/202010/be-well-informed-active-self-manager-your-medical-care.  Patients can reduce the possibility of iatrogenesis and medical errors by informing themselves to the extent possible regarding the nature of their medical conditions and the availability of appropriate, evidence-based treatments.  Preparing lists of questions ahead of time to pose to healthcare providers, and continuing to ask questions about symptoms and treatments throughout the illness episode, are essential steps.  The utility of question-asking is enhanced by bringing a family member or close friend to medical exams and consultations and audio-recording these encounters.  Paperwork documenting the treatment plan, outlining possible side-effects and complications, and describing required follow-up should be studied closely.  There are online tools that inform patients as to what to expect when undergoing a particular type of medical exam or treatment, identify potentially harmful drug interactions, and guide efforts to monitor oneself following treatment to evaluate the impact of medical interventions.  Patients should approach healthcare in the same manner they do when purchasing a house or car or planning a vacation.  Background research, questioning, and ongoing monitoring and information gathering, with the help and support of others, can make a difference in avoiding problems and errors and optimizing the benefits of healthcare.

Question 6

Do males prefer to see male physicians and therapists?

Richard Contrada · Accepted Answer

Gender concordance, that is, men receiving care from male healthcare providers and women from providers that are female, has been found to suit patient preferences, promote effective patient-provider communication, and in other ways lead to more satisfying medical encounters.

Question 7

Are there psychological traits or factors that might prevent someone from accessing healthcare even when they know it would benefit them?

Richard Contrada · Accepted Answer

Many psychological attributes and processes lead to healthcare use or non-use.  As your question implies, beliefs about the likely benefits of treatment do not play a dominant role on their own.  The decision whether or not to seek healthcare reflects other beliefs, such as those concerning its negative consequences, including medical costs, time lost from work, possible iatrogenesis, the anticipated aversiveness of certain medical procedures, and anticipated side effects of even effective treatment.  Social psychological factors include the stigma that may attach to seeking care for certain conditions.  There are also beliefs according to which accessing treatment would conflict with one’s self-concept or social identity, for example, those of a man who strives to adhere to masculine norms calling for toughness and strength, or those of a woman who believes she should put others’ health and wellbeing ahead of her own.

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