As pay for performance plans for physicians become more popular, there is an increasing focus on the gap between what doctors â€œorderâ€ and what patients do. Patients following doctorsâ€™ orders are considered to be â€œcompliant,â€ and those who donâ€™t are â€œnoncompliant.â€
Terms like â€œordersâ€ and â€œcomplianceâ€ put too much burden on patients. (It reminds me of how utility monopolies use the term â€œratepayersâ€ rather than customers.)
A family physician cited in todayâ€™s Wall St. Journal has started to follow up with patients after their visits.
[She] learned to her dismay that many didnâ€™t fill prescriptions or stopped taking medications because of side effects. She now puts all instructions for patients in writing, calls a few days after a visit to make sure they understood and checks with pharmacies to see if prescriptions have been filled.
Sheâ€™s starting to address the real issues of poor physician/patient communication and follow up, although sheâ€™s doing it in a very labor intensive way rather than using a productivity tool such as RelayHealth.
Patients do need to take more responsibility for their own health and engage more effectively with their physicians, but letâ€™s not call it compliance.March 9, 2005