Banish These Five Terms From Medicine?

Ariel Harsinay

Disclosures

September 26, 2018

5. Noncompliant

(adjective): refusing to comply with something

In an article for the New York Times,[10] Dr Danielle Ofri, associate professor of medicine at New York University School of Medicine, discusses the dilemma over calling patients "noncompliant":

As soon as a patient is described as noncompliant, it's as though a black mark is branded on the chart. "This one's trouble" flashes into most doctors' minds, even ones who don't want to think that way about their patients. And like the child in school who is tagged early on as a troublemaker, the label can stick around forever.

Ofri sheds light on the fact that compliance is not black and white; there could be a dozen reasons why patients aren't following their doctors' instructions. Ofri cites an article by Dr John Steiner in Annals of Internal Medicine,[11] in which Steiner created a chart for one of his patients with diabetes and found that if the patient followed all of his instructions by the book, he would have to complete more than 3000 behaviors annually.

Ofri also cites her grandmother's experience with heart disease to show the many different of adherence:

Had she taken her medicines at the appropriate doses, she might have survived the heart attack. But then maybe she would have died a slower and more painful death from some other ailment. Her biggest fear had always been ending up dependent in a nursing home, and by luck or design, she was able to avoid that. Perhaps there was some wisdom in her "noncompliance.."

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