Beyond 'White Coat Syndrome'
Fear of doctors and tests can hinder preventive health care.
Fainting Before the Needle
Although some medical procedures may make us nervous, fear of needles can
evoke intense reactions. Fear of needles is a recognized phobia, listed in the American
Psychiatric Association's DSM-IV manual within the category of
blood-injection-injury phobia, according to a 1995 study in the Journal of
Needle-phobes experience panic attacks, lightheadedness,
or fainting when exposed to a needle, according to the author, James G.
Hamilton, MD. (Hamilton says that 80% of patients with needle phobia also
report the fear in a close relative, suggesting the phobia has a genetic
A 2006 study showed that 15 million adults and 5 million children reported
high discomfort or phobic behavior when faced with a needle. Nearly a quarter
of those 15 million adults said they refused a blood draw or recommended
injection because of fear. (The study, which extrapolated from a survey of
11,460 people, was commissioned by Vyteris, Inc., a company that makes a patch,
called LidoSite, designed to relieve needle pain.) Hamilton estimates that
needle phobia "affects at least 10% of the population."
"Blood tests are one of the most important diagnostic tools modern
medicine has at its disposal," Mark Dursztman, MD, a physician at New York
Presbyterian Hospital, said in a news release announcing the study findings.
Fear of needles, therefore, is "an important public health issue."
Hamilton says needle-phobic patients deserve to be recognized as suffering
from an involuntary condition rather than being made to feel like
"wimps" or "oddballs."
Fear's Silver Lining
Fear can also be your friend when it comes to health care, Consedine says.
People who are more afraid of cancer or heart disease are more likely to
get screened for those illnesses, studies show. In fact, many people face
conflicting emotions about visiting a doctor, Consedine says. For example, a
man may fear the discomfort of a colorectal exam, but also fear the
consequences of missing a colon cancer diagnosis.
What determines whether we seek proper health care or avoid it? "Fear
aroused in the absence of any sense of what to do -- of a coping procedure --
is more likely to lead to delay and avoidance," says Howard Leventhal, PhD,
director of the Center for the Study of Health Beliefs and Behavior at Rutgers
University. If a person feels that a diagnosis will doom him, or that the
health care system is untrustworthy, or that he can't afford treatment, he is
more likely to let his fears guide his decisions.
Fear of Doctors: How to Cope
Here are some tips experts suggest to cope with fear of doctors or medical
1. Identify what worries you. Or as Consedine puts it, deconstruct
your anxiety. "Anxiety tends to be diffuse; people are not sure what
they're really anxious about. But if you identify what it is, that makes it
much easier to manage because you can evaluate your coping potential."