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One of the biggest complaints I hear from doctors is that their patients don't follow through with prescribed treatments, or don't get the tests that are ordered. That just makes no sense to them. It makes some of them angry.
I can see why they don't understand, but I also see many reasons why we patients don't follow through. Let's look at some of those reasons:
1. We're asked to do something that requires arrangements that are difficult to make. Maybe we don't have transportation, or we have to take time off from work. Physical therapy, or getting tests in a different location - we can't always make those arrangements easily.
2. We're asked to do something we can't afford to do. For example, we're prescribed a drug that is more than our budgets will bear. Or maybe we need some sort of surgery or therapy that our insurance doesn't cover.
3. We start to follow through, but stop or give up. For example, we begin taking a medicine that produces unpleasant side effects, so we stop taking it. Or we start a therapy and don't think it's really helping. Or we follow through, then stop when we think we're healed or cured or no longer infected.
4. We follow through - but only partially. For example, we take our once daily blood pressure pill only a few days a week because we forget it the rest of the time. Or the doctor says to stay off a sprained ankle, but hating crutches, we just try to baby it, but don't stay off it completely.
5. We try to follow through, and have good intentions of following through, but just can't do it. The doctor tells us to quit smoking or lose weight and despite our good intentions, we just can't manage to do so.
So why would our doctors be upset with us? Because so often, we return to the doctor with additional problems, upset because whatever our original symptoms or problems were, didn't go away! We try to make it the doctor's fault when, in fact, the doctor did what she was supposed to do....
Well.... almost.
The biggest problem here is that communications were lacking to begin with. If communications were happening effectively and efficiently then any of those reasons listed above for not following through (which, by the way, doctors call "compliance" or "adherence") wouldn't happen. Or if they did, the doctor would know about them as they happened.
And that's the point. When you establish a good, effective partnership and rapport with your doctor, that includes managing each other's expectations. If you decide together on a plan for treatment, then it's up to you to follow through, and if you can't, to let your doctor know that you can't, and why.
Can't afford those drugs? Telling her will give your doctor an opportunity to prescribe a different drug you can afford.
Problems with side effects? Then let your doctor know so she can figure out what to do next to help you.
Can't quit smoking? Then fess up - don't cover up! And ask for help. At least let your doctor will know you are sincerely trying to quit.
Of course, in the best doctor communication world, your doctor would discuss potential barriers with you to begin with, telling you what to do if you experience unpleasant side effects, or suggesting you make an appointment for therapy after work hours. Unfortunately, that rarely happens.
But remember - we are the ones who suffer when follow through doesn't happen. We need to manage our own expectations by sharing potential hurdles with our doctors, and learning what the consequences might be - by asking about them ourselves.
Communications with our providers require not just the initial exchange of ideas and decisions, but the follow through to make them happen as well.
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