If you consult a doctor, follow his advice – it’s common sense. Otherwise, you are wasting his time, your money and may put your health in jeopardy.
What do you do when the doctor hands you a prescription at the end of the consultation?
Do you race around to the local pharmacist, have it made up and diligently follow the recommendation on the label?
Or does it sit in your pocket for the next month while you hope nature comes to the rescue and cures your symptoms?
Or do you buy the medication, take three or four pills, and let the rest lie idly in the bottle while your symptoms thrive?
These are more than theoretical questions, for over the past year more and more doctors are looking at the situation which now goes by the term of “patient compliance.”
Indeed, it seems that some patients visit their doctors, then don’t even pay lip service to the advice offered.
No doubt many of them will complain vigorously later on, claiming the treatment was no good, their doctor useless and the visit a waste of time.
This problem is worldwide and seems to be accelerating. Quite often the subject is aired in medical journals from all parts of the world.
Like this recent piece in the British Medical Journal, Lancet, written by Dr. George Masterton from Glasgow and signed by himself and three colleagues.
“As doctors, we too readily assume that all our patients will carry out their treatment instructions implicitly. That they do no such thing, in Scotland at least, clearly emerges from a study of patients on unsupervised treatment.”
“Over the past 10 years, we have noted that 4 percent of patients do not ever start their treatment, while almost half have ceased to follow their advised treatment course within the first 14 days.”
Dr. Masterton then advocated courses of treatment as short in duration as possible.
“It seems that even feckless patients will complete or nearly complete an abbreviated course of treatment.”
For this reason, whenever possible, he and his colleagues always go for intense routines that last only a few days. He claims the results are often superior to longer courses which may be rejected partway through.
Perhaps one of the most common problems is to convince patients with an elevated blood pressure of the dire necessity for continuing treatment, long term, even if symptoms are not apparent.
This has produced a major community problem. The majority, it seems, simply are not interested in taking medication year in and year out for a serious disease when symptoms are not obvious to them.
The Americans are well aware of this problem, and recently the Journal of the American Medical Association published a leading article pointing out the frailties of patients to doctor readers, and suggesting ways of encouraging “patient compliance” with their treatment.
“Articles have recently appeared suggesting ways to improve patient compliance or adherence in the management of elevated blood pressure, a disease that requires continuous, long-term treatment and that most frequently is without symptoms,” the American journal began.
There followed a series of suggestions aimed at encouraging patients to stick to the medical routine.
Elevated blood pressure, technically known as hypertension, is one of the five well-established causes of sudden death from a heart attack. Yet people with very high-pressure readings will often totally ignore repeated warnings, and fail to take their medication as instructed. They are inviting doom and disaster. In many cases, it is simply a matter of time before trouble strikes.
“If I feel OK, then I must be OK” is an attitude common among Americans. It is unfortunately common among people all over the world.
Dr. R. Haynes and a team of six other physicians from McMaster University Medical Centre in Ontario, Canada, checked the 5400 workers in the Dominion Foundries and Steel Company and found 245 had elevated blood pressure.
They formed two groups of the patients and gave treatment instructions only to one group. The other group was given similar treatment, but each member was given a series of duties as part of the treatment. For example, each one had to record his pressure daily, write down how many pills he took and when, had regular supervision by a medical person every few days.
Six months later, the unsupervised group showed a marked fall in medication compliance, and few showed any real fall in blood pressure. In contrast, 85 percent of the supervised group showed a major improvement in blood pressure readings.
“This showed that effective compliance-improving strategies can be applied, maintained, and supervised.” Lancet later reported. So the case is not as hopeless as many doctors often feel.
However, about the same time, Lancet also printed a survey carried out by Dr. W. Waters in Yorkshire. This showed that “seven percent of prescription forms issued were not presented to the chemist. Those least likely to present them were men aged 25 to 34 years.”
“Drugs affecting the heart, painkillers, sleeping pills and tranquilizers were rarely rejected,” he pointed out.
The most likely ones not to be made up were prescriptions for the relief of mild pain, coughs, bowel upsets, and skin disorders.
Often simple symptoms the patient complains of can develop into more sinister disorders. Treatment carried out promptly will often prevent the development of more serious problems.
The object lesson of my professional lifetime was a 36-year-old woman who always brought her children to my rooms for any illness. She was a good mother, and properly supervised their medication.
Occasionally she mentioned some “bleeding from the bowel,” but was always “too busy” to have herself examined.
She consistently refused. Five years later she developed an “acute abdomen.” Surgery revealed a massive cancer of the bowel. She died less than six months later. Being “too busy” cost her life, and left a young family with no mother.
Do what your doctor suggests. He is there to assist and cure you. It may seem a burden at the time, but the payoff could also save your life.