When “nudging” doesn’t work to change patient behaviour

by Carolyn Thomas     @HeartSisters

CAROLYN’S WARNING:  this article contains a C-word that drives many chronically ill patients stark raving bonkers. Continue reading only if you can stomach the word “COMPLIANT”

Dr. Aaron E. Carroll wrote a compelling essay in the New York Times recently. (By the way, I’ve often wondered why so many people – mostly men, I’ve observed – insist on formally using a middle initial? Is it to differentiate them from all of the other Dr. Aaron Carrolls out there?)*

Dr. Aaron E. Carroll’s subject has intrigued me ever since 2008 when I was told in the CCU that, from now on, I needed to take this fistful of new cardiac meds – many of them every day for the rest of my natural life.

Pesky patients who, for whatever reason, do not follow doctors’ orders represent a perennial frustration in medicine. Sometimes the consequences of not being “compliant” (or “adherent”, the slightly less patronizing term) are brutal, so this decision not to can be deadly serious, accounting for two-thirds of medication-related hospital admissions. And more to the point, it begs the question of how to convince people to do what the doctor says they must (or, as some people – but not me – like to call it: “how to make non-compliant patients compliant”). Continue reading “When “nudging” doesn’t work to change patient behaviour”

First, there was compliance. Then, adherence. Now, concordance!

by Carolyn Thomas     @HeartSisters

Non-compliant patients who, for whatever reason, do not follow doctors’ orders are a pain in the neck to their physicians. But to me, the most problematic part of that statement is the use of the word non-compliant. Simon Davies of the U.K.’s Teenage Cancer Trust once described it as “a word that sounds like it has punishment at the end of it.”  Yet physicians are frustrated about why so many of us still refuse to take their expert medical advice, particularly around taking recommended medications.  Continue reading “First, there was compliance. Then, adherence. Now, concordance!”

If you’re clueless and you know it . . .

I am clueless about many things. As in the definition: “Lacking understanding or knowledge.” As in the sentence: “I have no clue!” As in the 20+ years I spent living with a research scientist and enduring mind-numbingly torturous dinner party conversations about zinc and copper sediment in the Fraser River estuary.

That kind of clueless.
Continue reading “If you’re clueless and you know it . . .”

16 minutes that will change how you look at the “soul-crushing reality” of healthcare

Mayo Clinic's Dr. Victor Montori at TEDx Zumbro River
       Mayo Clinic’s Dr. Victor Montori

by Carolyn Thomas  ♥  @HeartSisters

I felt like weeping with joy and hope by the end of this TEDx talk by Mayo Clinic’s visionary physician, Dr. Victor Montori. It’s about healing healthcare with kindness and caring.  This is nothing less than a patient revolution to address what he calls the “soul-crushing reality of a healthcare industry that has corrupted its own mission.” Continue reading “16 minutes that will change how you look at the “soul-crushing reality” of healthcare”