UABDivulga - Barcelona recerca i innovació

In the field of health, it is acknowledged a given profile of user called overuser that saturates public primary healthcare services, generating burnout in professionals and increasing healthcare costs both in the use of resources and in medical expenditure. This translates into not only a disproportionate amount of consultation time but also into complementary tests and drug prescriptions. Overusers mostly report symptoms of anxiety and somatic complaints associated with physical sensations, body changes or new symptoms. With this type of demand, overusers expect to obtain from the general practitioners recognition of their symptoms, reassurance and empathy. However, the current health model does not offer an affective type of response but technique prescribing more medication or new exploratory tests. Consequently, as they do not receive a convincing answer to their non-organic discomforts, overusers undertake on their own initiative an over-utilization of public services.

A study carried out in 13 primary healthcare practices in Barcelona has analyzed the differential personality characteristics of these overusers that show a high frequency of patient-initiated consultations. The results have shown that overusers are characterized by the need to obtain affection, a low self-confidence, depression and dependence on others in order to maintain attachment. However, these personality characteristics do not suggest the presence of a disorder but denote a personality style.

Therefore, patient-initiated consultations can be considered an easily detectable marker for underlying psychological problems. By working together—general practitioners identifying individuals with excessive patient-initiated consultations and psychologists assessing psychopathology—both groups of professionals could act as gatekeepers, preventing such patients from over consulting and in turn lowering costs, professional burnout, and, most importantly, patients' suffering and discontent.