Let’s be real, some of us are ideal patients while the remainder of us could certainly use a little work in this arena. Admittedly, doctors are the worst. We know too much and adjusting to the lack of control that comes with the vulnerability of being a patient can often be too much to withstand. Self-defeating defiance requires constant managing. Then, there is simply the natural tendency of people in general to fib - yes, outright lies do fall heavily into the mix even from the most well-intended, and the why ranges from a resistance to self-acceptance of an upsetting reality (aka denial) to wanting to be perceived in a certain way.
When you think about it, how best might we empower our own individual autonomy (a core tenet in principles of bioethics)? By presiding over the narrative.
It is quite common for a patient to seek a physician’s thorough assessment and evaluation, get a proper diagnosis and treatment recommendation, and then patently disregard it for a social media crowdsourced “remedy” encouraged by acquaintances without medical licenses. Why is this the case? The reasoning can be well thought out to outright reckless, but such is the messiness that is being human. Often, people tend to do what they want routinely pursuing the path of least resistance. In so doing, they traditionally pay later in either protracting their illness or delaying and complicating necessary treatment. Avoidance as a coping skill can do much harm when taken to the extreme.
Minimization is quite the adaptive function often employed to deceive ourselves when a diagnosis exceeds what we can bear. This often flawed coping mechanism is responsible for our selective picking and choosing what is really worrisome. In diseases whose prognosis is particularly upsetting like cancer, it is not uncommon for patients to get hyper-focused on a particular aspect of therapy - routinely one that lacks much relevance in terms of survival. But, this active grasp to retain control can serve to help the individual survive such an unpleasant, stressful time. When so much is out of control, taking charge of things particularly meaningful or not can be a vital tool to thriving in the chaos of the unexpected and overwhelming.
Look no further than excessive doctor shopping or even opinion seeking. It is quite common for people to seek an answer they want. That’s why confirmation bias is a thing. How about compliance, in general? Prescription sharing from antibiotic to Ambien is so rampantly not feared that we are harming ourselves - spurring dangerous side effects and addiction in the process (read here).
Medication mistakes outside of a healthcare facility are on the rise and resulting in serious outcomes—with home locations leading the pack. According to a 2017 study that tracked unintentional therapeutic pharmaceutical errors and focused on those causing profound impairment, disability and death, there was a 100% rate increase from 2000 to 2012. The why depends a lot on the who as stage of life considerably influences the problems that arise and the causes of them. To learn more about this in great detail, review here.
Telling your doctor you were fully compliant when you weren’t is pretty standard fare. The hazard it can do is directly correlated with the subject matter at hand. Or, not wanting to disclose personal habits and tendencies out of fear of being scrutinized is also a common worry. Finding a physician you trust in which you can deepen and develop a therapeutic relationship is the best way to overcome these many all-too-human foibles. And, any physician who is especially judgemental probably isn't such a great doctor anyway- so, find a new one if that is your experience.
The good news is doctors appreciate the complexities of humanity. The drive to be well and not preoccupied with disease is a healthy one. How we cope and help ourselves in the process when we do encounter a bump in the road can definitely influence how difficult we make the ride. Seeking caregivers with whom you feel most at ease and can be yourself around is a necessary start to a more honest, helpful, invaluable and effective therapeutic approach. Creating the environment best-suited to facilitate your compliance will yield the greatest dividends in your treatment outcome and survival.
You have more power than you might think, even in the most unimaginable of circumstances.