Compliance.  I really hate that word!  The general impression given throughout the blogosphere is that patients:

  1. don’t take their medicine
  2. prevaricate

A few typical quotes:

  • Comp-LIE-ance:  “There are only 2 settings where compliance actually takes place; controlled substances and patients with high copays/no free ride.
  • On Your Own With Multiple Meds:  “Even though people ‘know’ they should take their pills as directed, for the most part, they don’t.

It drives me crazy to read accusations such as these.  I  am a patient.  I don’t have a high co-pay, and I’m not taking narcotics, but I’m highly motivated to do everything in my power to retain the ability to walk and dress myself, so I take those pills religiously.

It’s condescending to assert that patients have an obligation to comply with the doctor’s treatment plan.  In an attempt to avoid the word “compliance,” now patients are supposed to “adhere” to the doctor’s treatment plan.  Nomenclature is irrelevant.  It’s still condescending to dictate from on high how patients ought to go about living their lives.

The problem is that it’s the doctor’s plan.  Without buy-in from the patient, it just won’t work.  People do things when it’s to their advantage to do them, and they don’t do them when the costs outweigh the benefits.  It applies to other areas of life, and there’s no reason to think that the same philosophy doesn’t apply to medication.

If a patient says, “The doctor wants me to take all these pills, but I don’t see the need,” then it isn’t the patient’s treatment plan, it’s the doctor’s.  Patients have buy-in when their explanation becomes, “I have a medical condition that could kill me, but there are prescriptions that give me a better chance of survival.  I want to live as healthily as possible, so I’ll take these prescriptions the way they’ll be most helpful, and follow-up with my doctor to monitor my progress.”

Compliance with a treatment plan happens when it’s the patient’s treatment plan.

I am fortunate to have doctors who don’t talk down to me.  They listen to me, they answer my questions, and they don’t act like I’m too stupid to understand the basics of what’s going on with my health.  It’s not easy to take multiple medications, but my doctors have made it as easy as possible by explaining why this is a good treatment plan.

What do you think?