When I wrote this blog on November 6,
2015, I used the reasons promoted by the American Medical Association
(AMA) and they are valid reasons. Now I will list more reasons that
I feel most doctors refuse to consider.
These are the reasons I feel should be
considered:
Communication improves health
outcomes. My blog here helps explain this and would reduce drug
non-adherence greatly. Without communication, patients may not
understand what the medication is for and do not know what side
effects may happen and this will increase non-adherence.
Not understanding patient's
finances. This is often not a consideration for doctors and they
prescribe the more expensive drugs rather than generics. Yes, this
can be like cost in the previous blog, but I want to emphasize that
too often doctors only care that their bill is paid and too often
prescribe an expensive drug they can receive incentives for
prescribing.
Patients looking for natural
treatments. This is the bane for all doctors, but they need to
understand these people. They do not care how large the fistful of
prescriptions might be. They just accept them and as soon as they
are out of the office, they stuff them in a pocket or purse and they
are off to visit the nearest health store to ask questions and see
what the salesperson recommends. Or, they are looking for something
a friend or relative recommended.
Patients looking for a quick fix and
get out the door. These patients think that a doctor is like an
auto mechanic. A little bottle of medicine here, and a shot there,
and they will be as good as new. Even many patients with diabetes do
this and feel that this is the twenty-first century and there has to
be a cure. Some even accuse their doctor of hiding this from them.
Patients that have a symptom for
everything. They will not let the doctor go until they have
explained the symptom (most of the time may be non-existent) and try
to convince the doctor to investigate by doing this or that test.
These patients can easily be classed as hypochondriacs. They are the
dread of every doctor. When the doctor suspicions that they don't
have the symptom, they often accuse the doctor of not staying current
in his education and become belligerent.
There could be many more, but these and
the prior blog cover many reasons for patient non-adherence. Some
are definitely the fault of doctors and others are the fault of the
patient. I will always blame lack of communication the chief culprit
and doctors do not like this. I have asked a doctor for a generic
and was told that the generic was inferior in quality. As I was
leaving, I quipped that he would not receive money for the generic.
I received no answer and talked to the pharmacist who called and was
told that he had prescribe the brand name for a reason.
She then said he will not let me fill
the prescription. I told the pharmacist that I would see another
doctor and see if he would prescribe the generic. She suggested two
doctors and when I said one of them, she called to see if he would be
able to see me the next day. When she had the appointment, she told
the doctor I was taking a medication and gave him the brand name and
the generic name. She gave me the office number, location, time and
generic name and said he would give me the generic medicine.
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