Page 4 - DMN3Q21

FOR NON- COMPLIANCE TRY THIS:
RECOMMEND
2-3
"KEY" HEALTH IMPROVEMENT RECOMMENDATIONS
We as clinicians have used the term non- compliance for years. In fact, I recall this being among the first medical terms that I learned once
I started my clinicals as a third year medical student. As my training progressed I recall using the term a bit more often. I used the term non-compliance whenever I learned there was a prescription medication that “apparently”
had not been picked up from the pharmacy. I used it for patients who had been seen in clinic before but by my summation were just not taking on the responsibility to get better. Fast forward-I find the term now to be ubiquitous!
I don’t think I have heard grand rounds, journal club
or care management presentations without hearing the word at least once! Thankfully as physicians gain greater experience and become more seasoned they learn that Non-Compliance is not what it may appear. The term implies intent meaning—the patient “willfully and with intent” chooses NOT to do what is needed based on the advice and recommendations of their trusted physician whether it is medical adherence or post-surgical care. But
wait, we have been at the practice of medicine too long
to just accept this. We know better, which is why it is far more appropriate for us to use the term “non-adherent.” Characterizing a patient or patients as being non-adherent more clearly reflects the reality of practicing medicine
and brings into play circumstances that influence the patient’s ability to carry out our efforts regarding medical advice, recommendations and acting upon the benefits
of health education. Unlike non- compliance, the term non-adherence by definition includes unintentional inability or refusal by the patient to comply. This could mean the patient is dealing with being overwhelmed, does not/cannot understand, has a sense of helplessness or hopelessness, is confused, and/or is concerned about or unable to manage the healthcare cost. Okay so you still ask what differences are we talking about, don’t physicians end up with the same problem whether it is non-adherence or non-compliance? The answer is “yes.” The truth is this-- whether it is non-adherent or non-compliant behavior
by patients, physicians still struggle with the uphill
4 Detroit Medical News Third Quarter 2021
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