Maybe we should stop calling it “compliance”

As pay for performance plans for physicians become more popular, there is an increasing focus on the gap between what doctors “order” and what patients do. Patients following doctors’ orders are considered to be “compliant,” and those who don’t are “noncompliant.”

Terms like “orders” and “compliance” put too much burden on patients. (It reminds me of how utility monopolies use the term “ratepayers” rather than customers.)

A family physician cited in today’s Wall St. Journal has started to follow up with patients after their visits.

[She] learned to her dismay that many didn’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.

She’s starting to address the real issues of poor physician/patient communication and follow up, although she’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 let’s not call it compliance.

March 9, 2005

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