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
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