There is a term that healthcare professionals use that makes so much sense to us but may feel very derogatory to patients. Non-compliance.

I have had a patient complain to me, while I was on Leader Rounds, that they had been called non-compliant. They expressed embarrassment and frustration and told me that it was not true, they were compliant! I spent time letting them know that it was only the way it is stated and is not meant as an insult. But was I fully transparent and truthful?

What is the definition of non-compliance? Well, it means that one does not comply with what is asked, that’s easy.

But what does it mean to the healthcare professional, if we are honest, completely honest, even in our frustration. It might mean the patient is not doing what we asked, sometimes it means the patient ‘won’t’ follow our instructions, sometimes it means they don’t care enough to get better, or it might mean they do not understand how much we know, or, that they just don’t listen.

Okay, let’s sit with the patient for a minute, what does non-compliance mean in their minds?  When those words land, they can sound accusatory. It can sound like I, the patient, don’t care. It may sounds like like I am stubborn or not smart enough. It can even sound like ‘they’ don’t think I want to be well.

So, let’s take the 10,000 foot view, what does non-compliance mean? It means that the request was not complied with. There is no attitude in that term, there is no intelligence implied or denied, there is no resistance married to the expression. As healthcare professionals we can stand on that; but does that help if it causes feelings of judgement passed on to the patient?

As healthcare professionals, what is it we really want? Do we want to be right, to be in charge, to be the smartest, the one who wins? I mean, if we look way down into our deepest feelings, can we say none of that is present? And if we can’t, then how do we take that out of the equation.

In the end what is the final goal, to have the patient comply with what will achieve their greatest health. That should be a ‘drop the mic’ moment. We are here to help the patient achieve their greatest health in their life circumstances right now.

Well, then I say, we find another way of expressing this lack of applying alll the instructions we have given, that does not insult. If there is a feeling of not being trusted, on the patient’s side, there will be a barrier to them being able to comply with all instructions. Until we do that, I believe, as healthcare professionals, we need to take part of the blame for non-compliance.