When surgeons publish their results they include statistics regarding how many patients did well, and how many didn’t. When the authors breakdown their failures, a major consideration is non-compliance.
That basically means that the surgeon is blaming you for not following his/her instructions.
Many surgical failures are attributed to non compliance. It’s very easy (and safe) to blame the patient.
After all we explained everything clearly…
But…
Did we??
Did we ask if the you understood the restrictions?
Did you understand the implications of non compliance?
My own experience shows that despite long discussions, there exists a gap between what I meant and what you heard…. and understood.
So the next time the failure of a surgical reconstruction is blamed on a patient due to
non-compliance — perhaps we as surgeons should determine if it was instead a result of poor communication.
Bryan Vartabedian says
That’s a big yes, my friend. My friend Joyce Lee might suggest that it’s a failure in design of the discharge process. Communication design, perhaps.
Some folks prefer to refer to this as an adherence issue rather than one of compliance.
Howard J. Luks, MD says
Thanks for stopping by Bryan. I agree with Joyce Lee. It is a failure on multiple levels. Pre-op, post-op, and in follow up in the office. Would be more than happy to participate in the redesign :-)
Bill Hartmann says
Too often I have found that the discharge instructions are given by a nurse, AFTER the doctor has left. And they can’t answer my questions.
After several surgeries I have received instructions “to resume current medications”. But makes no mention about the aspirin & fish oils that where stopped before the operation to reduce bleeding.