As a laryngologist, I specialize in treating throat conditions. Often these are chronic and affect quality of life. Management, therefore, is often a combination of medical therapies with lifestyle changes.
Recently, a return patient came to see me in clinic. As I spoke to her, things seemed familiar. Her complaints were almost word-for-word what they were six months prior. When I asked her if she had tried my recommendations, she shook her head. I wondered, what had happened?
Why are some patients noncompliant? The answer to that can be quite complex.
There can be mistrust in the health care system or provider, limited access to care (transportation, days off, financial abilities), or even a misunderstanding of the directions given. Out-of-pocket costs can be cost-prohibitive even for over-the-counter medications. However, following recommendations is important. These are made not only to improve symptoms and quality of life, but in some cases, prevent progression of disease and illness.
So how should patients and providers navigate this dilemma?
As a patient, I recommend speaking up and asking questions. This is your time to get clarification on terminology, diagnosis, alternative treatment options, and how treatment will affect you. Always review your after-visit summary.
As a physician, I conclude the visit with a summary, but I also ask the patient to verbally do the same, reinforcing the plan. I provide written educational handouts on common topics for further reading. I schedule a follow-up. And finally, I work to create a safe space in which they can express concerns over the plan. I may not be able to address all the concerns, but I will try.
As health care providers, we must remember that good care does not only mean making the correct diagnosis. It comes from the connection we make with our patients that empowers them to make the right decisions for themselves.