Yep, I've seen people on full disability for an anxiety disorder..
As if there was any doubt in your head, the insides of their homes are exactly as you'd expect. 50" flat screen TV, xbox/ps3, computer with wireless internet, surround sound, a car that probably has $20k-$30k invested in it. I work fire/ems in one of these neighborhoods, it's absolutely maddening, and we see the same patients you see; asthma patient who can't afford her albuterol (but has a carton of cigs and a case of beer nearby), morbidly obese patients smoking while on oxygen c/o COPD exacerbation, diabetics who seemingly refuse to keep their blood sugar in order.... but I digress..
I too ask myself how long this system is sustainable. Every one of these patients that we stack into the ER (which will invariably go on diversion) is costing ME money <sigh>
I think there are two things that anyone going into the medical field should keep in mind.
1. Anxiety disorders can be hard to control and severely debilitating.
2. You cannot always tell how much a disorder or illness impacts the patient from a clinical examination.
I speak from experience as I have early onset OCD, which is actually a basal ganglia dysregulation disorder, more similar neurologically to a movement disorder like Tourette's or Parkinsons, and can be innate or caused by physical damage, and I have a neuromuscular disorder with intermittent symptoms.
My OCD generally does not respond well to medication, and my childhood was characterized by trying one medication after another with little positive result, and a lot of negative results. I was hospitalized once and was so fed up at one point that I begged them to try a bilateral cingulotomy. I had become severely sleep deprived due to the OCD to the point where I had started having seizures.
I was on SSI for the first few years of my adult life while I tried to find a way to manage my condition. SSI is not easy to get. It takes a lot more than one doctor's note but I had a medical file as thick as a phone book documenting my condition from the age of 6. At the time I received $600 a month. $400 went to rent, utilities and it was supposed to include my portion of food as well but it was usually the case that there was nothing to eat. The $200 that remained was supposed to go to transportation costs, personal hygiene items, medical care not covered by medi-cal, and clothing when needed but I frequently had to put it towards food. Needless to say, I ate a lot of cheap breaded items and most of my clothes were on their way out.
If you know people on SSI who are driving cars they spent tens of thousands of dollars on, or who are buying flat screen TV's, I can assure you they didn't get that money from the social security administration.
I did have a gym membership, however that was to get rid of the 100lbs I gained from the medication that didn't work.
I eventually got the OCD under control and am no longer on SSI, but I still have a hard time driving...I can't shake the feeling I've ran over someone when I hit a bump, and when I get stressed I have a hard time controlling it. I used to re-write homework problems compulsively in school because I didn't feel I was doing it right even though I was, and this would consume me for 10 hours straight sometimes.
The neuromuscular disorder was consistently missed by clinical examinations because most doctors aren't familiar with it and I was frequently asymptotic when I was examined. I could be fine one day and not fine the next. I could be fine one hour and not fine the next.
Remember we have all of these fancy medical tests now days because there are a lot of things that can't be detected on clinical evaluations. Eventually a person is going to come to you who is at the end of their rope because they are struggling with some condition that has severely impacted their lives and has been brushed off by other doctors who were just not knowledgeable about it or were of the erroneous opinion that if they couldn't see that something was wrong then nothing was wrong, and you're going to brush them off too, and they're going to go and kill themselves, because that's how depressed people who are struggling with undiagnosed or invisible conditions can get.
It's your job to have understanding for these patients, not doubt them when they say something is troubling them. If you can't understand that then you shouldn't go into medicine.