By Tina Rosenberg
Doctors are very good at telling us what to do — but we are very poor at doing it. In fact, the health problems of millions of Americans are directly related to our failure to follow doctors’ orders.
Doctors tell us to take our pills, exercise, go get that C.T. scan, stop smoking, change our diets, cut out salt, quit drinking, monitor our blood sugar. We know we should do it, but we very often don’t. About three-quarters of patients do not keep appointments for follow-up care. In one study of diabetes patients, only 7 percent were compliant enough with their treatment plans to control the disease. Even people at grave and immediate risk do not always take their medicines: a quarter of kidney transplant patients in one study did not take their medicines correctly, putting them at risk for organ rejection. Among elderly patients with congestive heart failure, 15 percent of repeat hospitalizations were linked to failure to take prescribed medicines. And compliance with exercise and diet programs is even worse. Poor compliance is a major reason that sick people don’t get better, and that our health care costs are so high.