The worried well

The negative phrase ‘the worried well’ is being increasingly used, particularly by policymakers and now by some clinicians as well. Usually, it describes a group of patients who are perceived as using health services inappropriately or disproportionately, when other more deserving patients should be given attention. It thus reflects the old idea of the deserving and undeserving poor, and is equally distasteful. There are numerous other reasons why we believe that this term is always inappropriate and should therefore never be used. The ‘worried well’ are not a clearly defined group — the only shared characteristic being that the doctor does not see pathology. Patients with this label could range from someone with a concerning symptom that turns out to be nothing, to someone with severe health anxiety. The term suggests that these patients are well; however, for some patients, the condition of health anxiety, for which the term ‘worried well’ is often used, is a serious and potentially debilitating condition. When investigated, one group labelled as ‘worried well’ were found to have substantial mental illness1 and therefore these patients need medical help.2 For doctors, it is wrong to imply that …