The Myth of The “Non Compliant Patient”
Helping People make Behaviour Change
Forgive me people, for I have sinned.
I have put the “non-compliant” label on people that have come to me for help. I have judged people who haven’t been able to do what I have told them they have to do, for their own good — without considering my role in this as a Clinician. I am glad I know better now.
When we label someone “non compliant” to treatment, what we’re really saying is that we didn’t do a good enough job of hearing them and meeting them where they’re at in life. Be didn’t mix the science with the art, we didn’t truly consider what is meaningful and we didn’t form a partnership with them to help them get better. Perhaps we were pushed for time, we had our own “stuff” going on, or it was just too hard to summon up the personal resources required for empathy. Sad but true excuses for neglecting patient care.
If we don’t hear someone’s story, and be able to empathize with them and resonate fully with them and their current life journey, we miss an opportunity to access the parts of their brain that can see the benefits outweighing the costs of behavior change. We miss the golden opportunity to show someone what’s in it for them — and help them down the right road. We miss the opportunity to show them that we care if they take their medication or not, if they come for a check up or not or if they overuse analgesics or not.
If we don’t hear someone’s story, we also miss the ability to meet them where they’re at in life. Instead of hearing their story, we judge and we blame. Blame people for not fitting in to the medical box of what we think SHOULD happen — that people should do what Medical professionals tell them to. We judge the lazy and undisciplined fat person — who is medicating their sadness and loss with cupcakes. If you’re already judging someone, they’re not going to tell you about the loss and the grief, and that the only way they currently get a reprieve is through some small window of sugar-induced happiness. You’re just going to set them up for more judgement of themselves, and to ultimately fail at whatever goal you’ve imposed upon them.
Diagnostics suck. Really. Especially when you reach the “Wild West” of medicine that encompasses suffering; pain, depression and chronic disease. We need to collect better data to be certain about diagnoses and improve monitoring, however a better diagnoses also enables us to use clinical kindness . At best we’re able to advocate for self-care and self-respect as healing modalities while the science is used best for intervention, and as a minimum we’re the cheer squad for small but meaningful change in the right direction.
If your clinician gives you a list of ten things to change, three books to read and a list of exercises that must be done twice a day, everyday — then perhaps you’re the one that needs to give them a walk up call and label them instead as a non-compliant practitioner.
