Every Halloween, I take note of some of the most infamous Doctor costumes, ranging from the mad scientist who created Frankenstein to Dr. Jekyll and Mr. Hyde. Even if you don’t dress up as a doctor, there’s enough medical paraphernalia that contributes to costumes including all that medical gauze for the perfect mummy costume, the skeleton head for your porch, or the fake blood for the perfect vampire or zombie. This does beg the question, what is it about doctors and healthcare that is scary? As it turns out, fear of doctors and healthcare is very common. Here is a short rundown of the more common healthcare-associated phobias.
- Iatrophobia is a fear of doctors. Interestingly, these phobias are actually types of social phobias in which the afflicted is afraid of interacting with the doctor, discussing their personal illness, or being examined. Some suggest that ‘white coat syndrome’ or higher blood pressure in the doctor’s office is part of this syndrome.
- Dentophobia is the fear of dental care or dental procedures. Unlike iatrophobia, this is quite common and some sources cite estimates as high as 75% of Americans suffer from some form of ‘dental fear’. Some suggest this is actually a variant of post-traumatic stress disorder due to the pain associated with a prior dental procedure. Not surprisingly, the dentist’s professional demeanor is also important. Anyone scared of Willy Wonka’s dentist dad in Tim Burton’s Charlie and the Chocolate factory?
- Nosocomephobia is fear of going to the hospital, which is either related to fear of death or could also be related to fear of contracting illness or disease (germophobia initially described in JAMA in 1910) and may be a variation on obsessive-compulsive disorder. Of course, it is important to distinguish this pathological fear from normal concern since hospitals are reservoirs for germs and disease and hospital associated infections are on the rise.
- Pharmacophobia is the fear of taking medicine, which is often related to fear of rare side effects due to a medication. This can sometimes manifest itself as medication ‘noncompliance’, which doctors often assume patients are intentionally not following directions. It is also often associated with prior adverse drug events. Perhaps the best known pharmacophobia is currently manifest as the fear of vaccines in which it is not the fear of the needle (see below) but the fear the risks of vaccination like autism or that the flu shot causes the flu.
- Needle phobia is a very common phobia. Some estimates say at least 10% of Americans are trypanophobic, and are likely to faint during a needle stick. This may even be an underestimate since those with needle phobia are not likely to seek medical care. This is a very serious phobia since needle phobia is characterized by very low blood pressure and shock when presented with needles, and there have been reports of patient deaths. Unfortunately, people with needle phobia often avoid recommended vaccinations and blood tests, placing them at higher risk of illness.
- Nosophobia is the fear of contracting disease. Perhaps the most classic example of this occurs in medical students (typically in their second year) who believe they or others around them are suffering from the symptoms of the diseases they study. Medicalstudentitis was reported as early as 1964, and it is still alive and well. One study estimated 80% of students suffered from this and a Facebook support group even claims 1000 members. Nosophobia can also manifest itself in patients who spend a lot of time online searching for causes of their symptoms. Cyberchondria is a type of nosophobia the unfounded concern that common symptoms are harbingers of serious disease due to online searching.
While these phobias may sound harmless, exaggerated or silly, it is actually important to identify people with these phobias and help them seek professional treatment early. Patients with healthcare phobias are likely to avoid seeking care for actual symptoms which places them at higher risk of morbidity and mortality. Now, that’s a scary thought!
–Vineet Arora, MD