About the author:

Howard J. Luks, MD

Howard J. Luks, MD

A Board Certified Orthopedic Surgeon in Hawthorne, NY. Dr. Howard Luks specializes in the treatment of the shoulder, knee, elbow, and ankle. He has a very "social" patient centric approach and believes that the more you understand about your issue, the more informed your decisions will be. Ultimately your treatments and his recommendations will be based on proper communications, proper understanding, and shared decision-making principles – all geared to improve your quality of life.

7 comments on “Compliance vs Participation … #hcsm #hcsmeu #pm

  • What a great question!I’d be curious to know if you’ve detected any patterns in the “non-participation”? Are there certain common characteristics of those patients that are “non-participating” (i.e. ones that have effective support systems at home; ones that need lots of positive reinforcement)? Are there certain instructions that they are more “non-participating” with? How effective is the hospital in supporting/reinforcing the instructions?Technology today presents so many options to help encourage/enhance engagement and “participation” but it is not a one-sized fits all solution. Text messages, podcasts, Facebook groups, virtual visits (individual or group), …. I could go on.

  • I like this term non-participant. It strikes cord with me. I’m willing to bet that those who are non-participants in rehab are also non-participants in their own life. Believing that things happen to them and that life is not something they have to actively engage in. Surgery is the “fix” not the rehab. I think that’s our culture tho too… Break yourself, medicine can fix you, be it pills, surgery (hello WLS) or whatever. People do not take responsibility for themselves. As for getting people to be more active participants in their own care? I’m not sure that you can? It’s really a question of motivation and that has to come from within. All the handouts and prodding (and nagging) in the world isn’t going to get someone one to do something that they don’t see to be in their own best interest. I rehabbed the heck out myself after my 3rd ACL fail but only because by then I knew better and I was very interested in affecting my own outcome, in ALL aspects of my life. That ah-ha moment I don’t think is something that you as the doctor can influence in someone who is disengaged from the get go.

  • Nice thought, Howard. But I agree with Sarah. The motivation to better one’s self must come from within. Taking responsibility for one’s actions is something that can be suggested, but not mandated – unless you try to penalize and that won’t work because those people are already not engaged in the system. So any penalty would only wash off their indifferent backs in the same manner.

  • P.S. I like the video thing, but aim it down towards your face, not up – otherwise it makes it look like you have a double chin! lol

  • LOL. Paul, so funny. I also have learned to check nose angle. Some videos online show more of that than we need. I love Howard’s video anyway – it makes me more brave to speak up, too.About the post: I am one to work for the “good” kind of compliance since it is usually for the patient’s own good. However, I *hate* the word “compliance.” It sounds like patients are children who should be punished if they disobey. Great idea to use a more neutral word with less baggage, too: participation.

  • Man, this Posterous login this is dicey. I just logged in with Twitter, and it told me I was logged in through FB! I clicked “Logout of FB” and without further clicks, it now says I’m logged in via Twitter. Anyway:Plus ca change, buddy. Your post prompted me to write something I was already doing, an article about the compliance/adherence issue, in Lancet, in… 1977. I linked it to here.

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