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Beyond Compliance, Adherence, & Concordance - Supporting The Patient’s Implementation Of Optimal Treatment

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When Alternative Healthcare Equals Noncompliance

April 17th, 2007 at 10:30 am · Allan Showalter, MD · Culture-Ethnicity · No Comments



Tempted To Noncompliance

Today’s post focuses on the penchant of a significant fraction of the population to choose the offerings of charlatans and shamans over those of scientific healthcare, leading all too often to noncompliance with medical treatment.

This excerpt from Prayer, Faith Is Fine, published in the Swazi Observer characterizes the problem.

Many of those who stop taking ARVs as prescribed are those who have been told to do so by pastors and religious leaders who tell them that they have been healed through prayer and that their faith means they no longer require the lifelong treatment. Others quit adherence after turning to the myriad of concoctions that are freely available on the streets with the dubious promise to heal AIDS and kill HIV.


Commentary

While this story is set in Swaziland, it is not difficult to imagine variations taking place throughout the world, including those countries with far more resources in the areas of healthcare, communication, and education. The thriving enterprises of mysticism, quackery, pseudoscience, and straightforward scams in the U.S. is testimony that national borders are no protection from such dangers.

To read this article is to be reminded that patient noncompliance is caused not only by miscommunication, side-effects of treatment, medication fatigue, and other miscues within the patient-clinician-interface but also by patients who opt out of the system of scientific healthcare altogether, preferentially placing their beliefs in one of the many available alternatives.

While I am aware of the limitations of scientific healthcare and willing to accept the possibility that some other system could prove as beneficial or more beneficial to mankind, I see little compelling evidence indicating that such a theoretical system currently exists. Until such evidence is revealed, I maintain that a fundamental requirement for compliance is the patient’s participation in the best available scientifically supported medical care and, consequently, that those of us involved in providing that medical care have the responsibility not only to practice our techniques carefully and skillfully but also to unapologetically promote the proven effectiveness of those techniques and insist that alternative healthcare methods similarly back up their claims of effectiveness.



The complete article from the Swazi Observer can be found at ~Prayer, Faith Is Fine~

Tags: Culture-Ethnicity