E-DRUG: Trust & Ethical Laws (cont)
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Dear All:
I'd like to contribute to this most interesting discussion of "compliance"
from the perspective of an utterly untrained but not unread occasional
patient: namely this: if, as several correspondents have implied, rational
therapy must be patient-focussed, you guys have really got to stop using
the term "compliance." Compliance, as any dictionary will atest, means
doing something at another person's demand, being obedient and submissive,
as in, "Sir, If you don't do what I think is good for you, you will die and
I will tell your children that you had a love affair with Richard Nixon."
That ain't what good patient relations is about, because "compliance" is
not what happens when an intelligent patient and her/his health care
providers agree on a course of action to improve the patient's condition.
That is an agreement, a compact, and a concord among mutually respectful
people, not authority figures and their subjects.
There is, you should realize, ample grounds for patients to be
constructively skeptical about the quality of advice physicians and
pharmacists provide.
The current issue of Consumer Reports magazine provides yet another example
of the appalling level of knowledge among pharmacists of the interactions
betwen commonly prescribed medications and the herbal remedies they are so
happy sell, even though none (that's none) are backed by enough evidence of
safety and efficacy to warrant FDA approval.
My guess is that the people who read E-DRUG are among the most dedicated
health care providers, and that my comments about competence apply to them
the least. [thanks for the compliment! - WB]
In any case, there is a need for a better term than "compliance." How
about "physician/pharmacist/patient accord?" I know it doesn't confer
the divine right of kings on the health provider, but hey, I thought you
guys were in this business to help, not to command.
James B. Russo
(this is just a personal opinion, so I feel uncompelled to give my
"official" affilication.)
jbrusso@aol.com
[I agree that the term "compliance" should be avoided as it is too
authoritarian. Similarly, "patients" should be called "consumers" or
"clients". What about "rational drug use by consumers"? In the case of OTC
medicines, we should probably aim for "rational, informed decisions by
consumers." WB]
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