#4. Oneupsmanship Or Compliance-Enhancement:
Choose One

More often than not, the first clinician to see the patient for a given ailment is actually providing a second opinion. It is the rare patient who does not arrive at a doctor’s appointment without forming an idea about what his or her symptoms portend. The source of the patient’s self-diagnosis may have been the New England Journal of Medicine, the Miracle_Snake_Oil.com web site, the 90-second personal health feature (inevitably called “To Your Health”) produced as a school project by the local TV station’s 19 year old intern, the overheard fragment of a conversation between two psychiatrists at a party, or my Aunt Hazel from Broken Arrow, Oklahoma. Even if the ideas are inaccurate — make that especially if the ideas are inaccurate — the failure to ask about and listen to these ideas is dangerous. That the clinician renders the correct diagnosis when he interrupts the patient’s prolonged account of recurrent dizziness, fluctuating appetite, and intermittent left knee pain does not insure the patient’s agreement, respect, gratitude, or compliance.

• Learning From Patient Noncompliance
• Patient-MD Alignment
• Dangers Of Making Noncompliance A Medical Condition
• Fixes for Today
• Systemic Alignment