Defining Patient Non-Compliance
In defining a patient’s non-compliant behavior the four criteria have been suggested: 1) Is the patient’s medical problem potentially serious or does it pose significant risk to life; 2) Has at least one treatment plan, been correctly followed. 3) Has the patient had easy access to the treatment or treatments; and 4) Does the patient deviate, significantly from most patients, with regard to medical advice, treatment, or follow-up care (Kliensinger, Fall 2003, p. 18).
Difficulty with Comply
According to Dr. John Steiner, a researcher at Kaiser Permanente, very few patients are fully capable of complying with all their doctors’ requests and or recommendations. To illustrate his point, he constructed a chart for a theoretical 67-year-old patient with diabetes, hypertension and high blood pressure. He then tabulated what it would take to be “adherent” with all medical recommendations: Five prescriptions to be filled monthly, getting to and from the pharmacy, (assuming he even has insurance), diet (cutting down salt and fats), exercise (three or four times per week), make it to doctors’ appointments, blood tests, check blood sugar, and on top of that, remembering to take the pills every morning and then again every evening eve...
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Fred Kleinsinger, M. (Spring 2010). Working with Noncompliant Patients . The Permanente Joural , 14(1): 54–60.
Holm, S. (1993). What is Wrong with Compliance. Journal of Medical Ethics, 19:108-110.
Kliensinger, M. (Fall 2003). In defining NCB, I use the following. The Permanente Journal, Volume & No. 4.
Roslyn Walden, M.-B. (2012, May 17 ). Dismissing a problem patient . Retrieved from Clinical Advisor: http://www.clinicaladvisor.com/dismiss-a-problem-patient-in-10-safe-steps/article/241629/.
The Fiduciary Relationship. (1993). Retrieved from biotech.law.lsu.edu: http://biotech.law.lsu.edu/Books/lbb/x236.htm
Valarie Blake, J. M. (2012, May ). When Is a Patient-Physician Relationship Established? The Virtual Mentor Volume 14, Number 5:, 403-406. Retrieved from The American Medical Association Journal of Ethics.
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