HPD Perspectives Magazine Summer/Fall 2019

NOVA SOUTHEASTERN UNIVERSITY | 43 Are patients becoming more educated, but at the same time more paranoid, more questioning, and even more challenging? There is a good chance that in the old paternalistic model, one of the prime motives for patient compli- ance was, to a degree, fear. If the patient did not do exactly as we said, it was believed there would be dire consequences. But, in general, that was an old societal behavioral trait. We did things out of fear of being wrong, causing problems, and alienating someone. From the 1930s into the 1950s, for instance, people still showed remnants of Depression- era behavior. DEMOCRATIC COMPLIANCE Originating in the 1960s, people wanted to fear less and control more. As we progressed and started to alter the patient- clinician relationship accordingly, we wanted the patient to share more responsibility in the deci- sion-making process. We desired a more educated, cooperative patient who complies not out of fear, but out of under- standing and confidence, with the added comfort that they are being heard. However, we must remem- ber that behavior earns respect— not necessarily the mere existence of a diploma on the wall or from where it came. TODAY'S GIVE AND TAKE There is a difference between intention and a patient’s perception. It is not enough for us, as clinicians, to know that we need the patient’s cooperation and to desire that the patient be open with us. It is also not enough to feel that we are sincerely interested in their total well-being. Our patients’ perceptions are reality. So, how do we exhibit sincere interest? This is where appearance, action, or behavior come into play. We must show interest in those under our care, not just think it. 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. DEMONSTRATING ATTENTION WHILE USING TECHNOLOGY In a recent TV commercial, a couple is seated in a restaurant. She is speaking, and he keeps taking quick looks at the phone screen on his lap. As she starts to express annoyance, he tries to show greater attention to her. There is a lesson in this scene for medical providers. Patients do not want to feel as though they are competing with machines to get our sincere attention. Today, we see patients and enter information into a database almost simultaneously. While working efficiently, we could easily give patients a wrong impression of our priorities at a time when we strive to create a positive impression anchored by our interest in them. They must leave our presence feeling they are our first concern. CIRCLING BACK TO COMPLIANCE It could be easy for us to sit back and assume we have a great deal of influence over the patient’s behavior when, in fact, we must earn respect and confidence. We must cultivate the kind of relation- ship that will foster compliance with our treatment not only when the patient is in our office, but, most importantly, when he or she is out of our immediate influence. During these changing times, we should continually ask whether our behavior could be demonstrat- ing less sincere interest—and registering as less concern over patient compliance. o Robert C. Grosz is a professor and course director in the Department of Physician Assistant—Fort Lauderdale Program. *Grosz R. “The Clinician-Patient Relationship: Going Through A Change?” The Internet Journal of Allied Health Sciences and Practice . 2012 Apr 01:10(2), Article 3.