January 30, 2014
My Perspective On Reasons Doctors Say We Are Noncompliant
This Medscape article has me riled. Doctors are complaining about a noncompliance epidemic and how to solve it. There are seven articles of several pages each and all are attempting to solve the epidemic.
I have an easy answer for them and I don't need over 30 pages to tell doctors the problem. Learn how to communicate with patients rather than ram medications down our throat. Most of the time these doctors just hand the patient a fist full of prescriptions with no explanation and expect the patient to fill each prescription and take the medication as directed. A small number of patients will comply with no questions asked. However, more patients are pushing back, want an explanation of what the medication is for, an explanation of the side effects, a benefits to harm analysis, and want a discussion of why they need it. Then even more patients desire to have some input in the decision of what may be best for them and openly rebel at being excluded by the paternalistic attitude of the doctor. Today's patient also wants more transparency on the part of the doctor and if he receives incentives for each prescription.
Most doctors refuse to take the time for any explanation and are upset with the patients when prescriptions are not filled and the patients refuse to take any medications. Their own lack of communication causes the majority of noncompliance as they deem to call it. These paternalistic doctors need a swift kick in the backside and be required to take and pass a communications course. It is the lack of communication not the miscommunication as they try to say in #7 below,
Doctors do not seem to care whether the patient can afford the medication as long as their bill is paid. They seem to forget that a little communication can do wonders for their practice and the confidence their patients have in them. I therefore say that the patient rebellion is mostly of their own causing. Yet, it is full speed ahead at blaming the patient, instead of looking at what they are doing.
David Mendosa is a bit more forceful in his blog from October 30, 2009. This was when more people were afraid to walk away from these doctors; however, today the doctors are forcing us to walk away more because of the over paternalistic attitude. With more people using the internet, we are able to understand the problems of pharmaceutical overreach and lack of communication about side effects that cause more harm than benefits for some people. I like a quote David used at the bottom of his blog by an endocrinologist friend, “The ‘noncompliant’ label always grated on me — it’s assuming a model of health care delivery that the doctor is the captain of the ship and the patients are chained to the oars.”
The following links will take you to each article: NOTE: These are written by doctors and for doctors – sort of an insight in the way we, as patients, are viewed.
Title - Why Are So Many Patients Noncompliant? - 9 pages
Title - Can We Get Patients to Be More Compliant? - 9 pages
Title - Documenting Noncompliance Won't Protect You Anymore – 4 pages
Title - Best Ways to Deal With Noncompliant Patients – 6 pages
Title - Noncompliance With Schizophrenia Therapy Usually Persists – 1 page
Title - Patients: 'Difficult,' 'Tough,' or Just Misunderstood? - 3 pages
Title - Why Some Patients Aren't Following Your Instructions – 4 pages
This is the master collection of the above articles