June 1, 2014
A Discussion about 'Noncompliant Patients'
While most doctors still label patients as non-compliant, a few doctors are speaking out against this and this doctor-to-be says even doctors are often the most non-compliant. It is called guideline non-adherence. I thought this was most appropriate and fit the discussion to a tee.
Elaine Khoong says, “What bothers me the most about this phrase, though, is how it’s often stated with such disdain. We act as if it’s incomprehensible that someone would ignore our evidence-based recommendations. If the patient would only bother to listen, he or she would get better. If we were patients, we would be compliant.
But that’s simply not true. We are no different from our patients. We practice our own form of noncompliance. Despite the fact that many guidelines are created after systematic reviews and meta-analyses – processes we would never have time to go through ourselves – we, like our own patients, are often noncompliant.”
I think she states this correctly and to the point. She does continue with more evidence about how doctors ignore guidelines and practice as they see fit. They ignore what they want to in the guidelines and use the parts they are comfortable in using. When they have not kept up with a treatment, they fall back to what is easy for them.
We see this with diabetes all the time and doctors just don't keep abreast with the treatments they are not comfortable in using. This is especially true when it comes to insulin. Why else would they stack oral medications on top of other oral medications? It is plain that they don't know enough about insulin to prescribe it.
The doctors then intimidate patients and belittle patients to stay on oral medications. Some even threaten their patients with insulin to keep them on oral medications. Then when the patients know that the oral medications are no longer helping them manage their diabetes, the doctors say they are non-compliant and say bad things to and about patients. It is clear that the doctors are non-adherent in staying current with the diabetes treatments and they will not admit it.
Fortunately, today there are more doctors and doctors-to-be that do not believe patients are non-compliant without a reason. Doctors that refuse to communicate and talk with their patients are the worst offenders. These doctors talk at or don't communicate with their patients.
The patients of today do desire more inclusion in their treatments and change doctors that exclude them in the decisions. Yet, these same doctors blame the patients for not following instructions when they don't follow the treatment guidelines.