Effect of patient demand for drugs on physician prescribing

In a controlled setting with symptoms and demographic variables held constant, differences in physicians' ratings of symptoms, diagnosis and prescribing of drugs were explored in response to six videotaped patients of differing age groups who either demanded drugs or presented somatic complaints. There was a 1.2:1 ratio of prescriptions given to female versus male patients; demand for drugs resulted in significantly lower prescription rates, drugs prescribed, and multiple prescriptions; and those patients who presented somatic complaints received significantly higher amounts of minor tranquilizers. Older patients were prescribed a significantly greater number of drugs than younger patients, particularly in the antidepressant classification, and differences in symptom ratings but not in prescription rates were seen between male and female physicians.