HPD Perspectives Magazine Summer/Fall 2019

42 | DR. PALLAVI PATEL COLLEGE OF HEALTH CARE SCIENCES Do we expect compliance from our patients? Should we expect compliance from our patients? In the traditional patient- clinician relationship, we en- gaged in a paternalistic model. Patients looked at us and saw success, knowledge, solutions, and safety. As a result, patients often became dependents, confessors, and/or believers. In an article in the Internet Journal of Allied Health Sciences and Practice ,* I addressed the clinician-patient relationship. In it, references were made to the changing clinician-patient relationship and the potential influence(s) on compliance. Some questions arose about what a clinician becomes responsible for in a patient relationship. If the patient presents with an acute medical concern, then there is no question. The knife must come out from the spleen, the rhythm must be reestablished in the heart, the dislocation must be reset/repaired, the gash must be stitched, and the antibiotic must be started immediately. If the patient presents with a chronic problem, we think a bit differently. Examples include losing weight and keeping it off, monitor- ing the diabetic, post-procedure rehabbing, a Prozac dose trial, and prescribing a decongestant. With acute medicine, emergency and “now” is more pronounced. However, with chronic medicine, “later” becomes more important. Thus, compliance becomes more important. This causes examina- tion of our influence over patients when they are in our presence, and when they are not. Obviously, we are surer of the former influence. AUTHORITATIVE COMPLIANCE Patients come to us for decisions in health and, quite often, various aspects of their lives, such as their intimate/interpersonal relation- ships, even financial advisement or what car to buy. In the past, we expected—indeed, often demanded— complete compliance. Because of the aura in which we existed, and the image in which medical professionals were thought of, our patients for the most part complied. Then the “drug bible”—the PDR ( Physicians’ Desk Reference) —was made public. As part of the effort to educate the masses and encourage some autonomy, it is possible that we spurred patients to question our decisions. Add to this the steady increase of TV/radio commercials describing disease symptoms and drug mechanisms. FACULTY PERSPECTIVE A Dying Concern Examining the Issue of Compliance BY ROBERT C. GROSZ, ED.D., ACSM FACULTY Perspective “If we earn their respect and their confidence, we stand a better chance of getting their compliance, especially when they are out of our sight.” —Robert C. Grosz