Sitting in a waiting room in emergency is a painful act in itself, isn’t it?
Last year my wife sat patiently with me as I waited to be seen by a doctor. I had been in the night before receiving a high dose of steroids through intravenous, and I was required to return for another; after several days the oral dose I had been prescribed was proving ineffective. I was very sick and was eventually admitted, but before that I waited several hours sitting on an uncomfortable 
chair reading old magazines and trying to sleep with one ear open, listening for the nurse to call my name. Looking at our watches, eyeing other patients with resentment when they get the call. We’re the most miserable group of people you’ve ever seen right?
“I was here before that guy wasn’t I? How come…I’m going to go talk to the nurse, I think they forgot I was here.” “Did you forget I was here, I was here before that guy? How many doctors are on duty?” as she patiently looks at you over her glasses with pursed lips.
The older man next to us looks at his watch again and tells us he’s been waiting since 8am, five and half hours ago, then another ambulance rolls up in front of the big emergency doors. Another hour. Good grief, someone else is jumping the queue.
What’s wrong with our health care system? Too much bureaucracy? Not enough doctors? Do we need more privatization or more funding?
Patient Compliance and Health Care
In the U.S. non compliance is estimated to cost 100 billion dollars a year. Yes that’s a b. Billion.
A HUNDRED BILLION! HOLY SMOKE!…Wait a minute. What’s non compliance?
Compliance is how well you follow ‘doctor’s orders’. Did he or she prescribe you medication? Did you fill the prescription? Did you finish taking the requested dose? What about exercise, vitamins, healthier eating? The one hundred billion dollar figure includes the cost of hospitalization, complications, advancement of disease, and disability or death due to non compliance. That’s a nice round figure, but needless to say, the effects are costly.
What do the statistics show?
- 14 – 21% of us wont fill our prescriptions.
- 30 – 40% only fill it once.
- 50% stop taking it within 6 months if prescribed for long term.
- 30 – 50% of all patients ignore or otherwise compromise instructions concerning their medication.
The rate of compliance seems to differ, but only slightly between those of us with “silent” conditions like high blood pressure, and painful conditions such as rheumatoid arthritis.
Research suggests we have any combinations of reasons not to comply; cost, forgetfulness, undesirable side effects, it doesn’t seem to work, other priorities, or down to lack of information–it seems 60% of us can’t even identify what medication we take.
So what does that mean to you when you’re miserable and sick sitting in the waiting room with a bunch of other miserable, sick people waiting to see a doctor? Potentially fifty percent of us may not even listen to the doctor when we do get to see him. We open our mouth, bend over, take off our shirts, get blood work, get a ct or x-ray, pee in a bottle and what ever else he or she might ask, but in the end we’ll go home and make excuses why we don’t follow through with their recommendations.
Was that you I was sitting next to while I was waiting in extreme discomfort?
Unfortunately that was me. You see I was prescribed a medication by my specialist years earlier but it was expensive and I was feeling better and it was a pain to remember, so I dropped it, and for a while it was fine. But years later, after two weeks of a three week hospital stay, another specialist informed me that I may never had been here if I’d have stayed on that medication. I felt offended, then angry, then angry at myself.
Was it true? I’ll never know. But imagine what effect it would have on our health care system if we were to take a little more responsibility, do our part to ease the strain on emergency staff, hospital admissions, or doctor visits.
It’s another case of knowing what’s good for us but not doing what’s good for us. Need to quit smoking? Need to lose weight? No more tasty MSG?
Strategies to combat non compliance:
After some research I found some suggestions and came up with a few of my own.
- You feel like crap, you’re anxious about having to see the doctor to begin with, and let’s face it, we don’t want to be there. Why not ask a friend or loved one to come for support? If your condition is chronic, look for support groups and forums. There are plenty online, or search one out in your community.
- Forgetful? Get a daily or weekly pill container – it seems simple but it works.
- Make sure you understand what it is you’re prescribed, what it does , what are the benefits/side effects, and what are the risks if you stop taking it.
- Don’t skip doses without first talking to your doctor or healthcare professional.
- Bring a notepad and pen. We forget almost half of what was said to us after we leave the doctors office (just ask my wife). Again another benefit of bringing someone with you if you can, and don’t hesitate to ask questions. Try repeating back to the doctor in your own words what he said to you.
- Listen to your pharmacist, ask questions and read the pamphlets.
While doctors and healthcare professionals search for different methods of intervention to reduce non compliance, accepting responsibility for our own healthcare will take us much further than passing it on, and in my opinion is necessary for us to attain the quality of life we desire, for ourselves and our fellow citizens.
Wait times are a problem for most of us across the globe, and there is no magic solution. Doctors don’t have all the answers, but if we’re going to take the time to see them, lets take the time to listen.
What do you think can be done to reduce wait times?
Author’s note: The article is to give an overview of my experience and research, I am not a doctor. Always consult your physician or medical caregiver before taking any action.
