This article is more than 5 years old. Information may no longer be current.
Enforce patient compliance when prescribing contact lenses, therapeutics
Click Here to Manage Email Alerts
It’s a scenario we all encounter, perhaps all too often. A patient presents for routine examination and, when queried, informs your technician that she’s a bit noncompliant with her contact lenses. Despite a well-documented medical record, it’s apparent she’s not following your lens care and lens replacement recommendations. In short, your professional advice has gone unheeded.
Occasionally, I find myself reflecting on this dilemma. Of course, noncompliance is much bigger than just contact lenses. It permeates virtually every aspect of optometric practice. Through the years we’ve learned that noncompliance transcends gender, race, education and even socioeconomic strata. It is pervasive in relatively low risk endeavors such as contact lens wear, as well as in potentially fatal conditions such as heart disease. And, historically, we’ve placed the blame largely on our patients. However, is it possible that we – practitioners – are at least partially responsible?
Is leniency effective?
Perhaps part of the problem is that we practice in an extremely competitive era, one in which patients are quick to seek second opinions or switch practitioners. As a result, practitioners may adopt a more “lenient” policy in an effort to retain patients rather than to create an adversarial relationship. Additionally, practitioners realize that patient care is much like other interpersonal endeavors in that you “choose your battles wisely.” In short, practitioners allow patients certain liberties —where appropriate — so as not to be viewed as inflexible. This is a strategy many feel is more likely to ensure patient cooperation when the stakes are high and compliance is essential.
But does this approach work? If we try to befriend our patients by condoning noncompliance, are we providing the best quality care? In essence, is it really appropriate for our patients to doctor themselves?
Granted, I’m certainly not one who believes practitioners should hand down mandates in a dictatorial and inflexible fashion. Rather, I firmly believe the best patient care strategy is one of compassion, understanding and encouragement. However, to provide patients with the care they desire and deserve, a healthy dose of professional advice is imperative — advice which is easily understood, logical and beneficial.
Explain treatment rationale
First, patients need to understand the rationale for treatment. For instance, a brief explanation of the allergy cascade and how certain therapies work goes a long way in helping patients understand the rationale for treatment. Second, your directives must be logical. Instead of allowing patients to randomly select contact lens care products, briefly discuss why a certain product regimen is more appropriate. Finally, patients must perceive the treatment as beneficial. This is of paramount importance in glaucoma management, where patients must be aware that the insidious nature of the disease often masks the consequences of noncompliance.
In short, when faced with a noncompliant patient we should not avoid the issue. Rather, we should seize the opportunity to address the issue, educate our patient and prescribe with authority. In doing so, you’ll win patient confidence, better serve their needs and assure yourself a healthy, vibrant practice.