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.
