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Monday, July 5, 2010

White Coat Fever

Doctor anxiety, otherwise known as White Coat Fever, is a collection of symptoms predominantly prevalent among people of all ages ages, races, creeds and sexes, which occurs when one is exposed to the presence of medical professionals or the anticipation thereof.

The term White Coat Fever is actually a misnomer, stemming from 19th century studies of English patients who mistakenly blamed their uncomfortable feelings when the doctor was in the house as the cause of their uncomfortable feelings. Likewise, people in the 19th century referred to any ailment as a fever.

In 1871 Dr. Al Buterol identified anxiety as the result of a phobia, or irrational fear of something or some situation that is generally considered to be harmless and, in the case of doctors, actually helpful. Accompanying that fear is a strong desire to avoid what you fear.

Yet the term White Coat Phobia never caught on, however, so we continue to use White Coat Fever as a generic term for what "doctors" more appropriately call Doctor Anxiety. Studies show, as you can see at, that a phobia can also be linked to your parents, as if you saw your parents acting "irrationally" toward doctors, or a particular procedure, you might have adapted a similar behavior.

Fear can actually be a good thing, if you are in the face of real danger, such as if you are staring in the face of a loaded gun, or if you see a car coming at you in your lane. Yet, in the face of normal, healthy situations or people, fear is not normal, and can actually be a bad thing.

The major complication of this condition is a person not obtaining the medical care they need. In the case of undiagnosed ailments, this can actually complicate care, and worsen the "fever."

Causes of White Coat Fever might include:

  • Traumatic experience, perhaps one you don't remember
  • Fear of contagious diseases
  • Fear you might get diagnosed with a disease
  • Fear of the person taking care of you
  • Fear you might get lectured
  • Fear of needles
  • Fear of blood
  • Annoyance of procedures you might have to undergo
  • Fear of medical instruments
  • Discomfort by someone touching you
  • Discomfort at anticipation of someone touching you
Symptoms most generally occur upon entry into the medical professions building, which can include, but not be limited to, a doctor's office, clinic or hospital. Despite common belief, the general hypothesis among researchers is that simple anticipation of physical contact or that the doctor might find something wrong, creates the anxiety and not so much the presence of the medical workers themselves.

Signs of doctor anxiety:
  • Rapid heartbeat
  • Biting of fingernails
  • Sweaty palms
  • Unusually quiet
  • Tapping on the chair, bed or table
  • Higher than normal blood pressure
  • Feel warm inside or even hot
  • Shivering
  • Saying stupid things
    Experts believe the best way of reducing doctor anxiety is by education. The more you know about your body, and the diseases you are diagnosed with, the less your anxiety will be. For example, if you are diagnosed with asthma, become an asthma expert by reading as much as you can about asthma.

    Although even asthma the most renowned medical experts can show signs of white coat fever while sitting sitting back in a recliner while being prepped for surgery.

    Experts surmise that good people skills also helps to reduce the amount of anxiety felt, although recent studies show this may not be the case. A recent study performed by a specialized anxiety group in Michigan studied 30,000 individuals who presented to various medical offices and emergency rooms across the country. Of those who participated, even those who noted good social skills noted at least some degree of doctor anxiety.

    Another way of reducing such anxiety is by being compliant with the medicine regime your doctor prescribes, and never quit taking your medicine without the expressed permission of your doctor. By doing this, you will be doing your part in the process of staying healthy.

    Included in the compliance department is avoiding situations that exacerbate your condition. For example, if you have asthma, you should work hard to avoid your asthma triggers. However, it is not advised that you avoid your doctor or other medical professional.

    Hence, the worse cases of doctor anxiety usually occur in the following avoidable situations, which are well deserving of a lecture:
    • Poor self care
    • Ignorance (poor education)
    However, as is mentioned above, sometimes doctor anxiety is not avoidable and simply just has to be dealt with in the best way imaginable that does not include skipping out on good medical care or advice.

    Ways to reduce doctor anxiety:
    • Educate yourself about your disease
    • Be compliant with your prescribed medicine regime
    • Be willing to make necessary lifestyle changes (i.e. quitting smoking, avoiding alcohol, avoiding allergens
    • Be willing to avoid social situations that tempt you to do things you shouldn't.
    • Visit your doctor regularly (at least once a year)
    • Understand that doctors are not better than you
    • Understand doctors are human beings not human doings
    • Research doctors and find one who works well with you
    • Be a team player with your doctor
    • Use common sense

    The awkward thing about doctor anxiety is that many individuals start to show signs hours, days and even weeks prior to such visits.

    The neat thing about doctor anxiety is the symptoms tend to go away once the white coat contact is complete. Yet, while it may seem the anxiety is gone for good, renewed anticipation may progress as soon as one learns of a new upcoming contact with the white coat folks.

    One myth is that the best treatment for other types of anxiety is to avoid whatever causes your anxiety, although when it comes to your self care, it appears the anxiety gets worse instead of better.

    Thus, the best wisdom regarding the prevention of white coat fever is to remember the phrase: Action Cures Fear. The more active you are in your own self care, and the more often you visit your doctor and work with him instead of for him, and the more medical wise you become, the less your anxiety will be when exposure in imminent.

    I think one of the biggest fallacies regarding medicine is some people find it easier to believe in old fallacies, such that second hand smoke is not dangerous, or that asthma will go away with age, or if I ignore my illness it will just go away.

    What cures doctor anxiety is not inaction, it's action. So become a part of your own health care team, get educated, be compliant, and become a team player with your doctor instead of letting him have total control over you.

    If you have what we define here as doctor anxiety, realize you are not alone, and that action cures fear.

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