Obeying doctor's orders: A view from the other side

Studies of patients' “compliance” with doctors' instructions have generally used an ideal image of the patient as a passive, obedient and unquestioning recipient of medical instructions, which is seen as irrational in the light of medical rationality.

Abstract

Implicit images of human behaviour influence most research endeavours. Studies of patients' "compliance" with doctors' instructions have generally used an ideal image of the patient as a passive, obedient and unquestioning recipient of medical instructions. Divergence from this ideal—"defaulting"—is seen as irrational in the light of medical rationality. The blame for "default" is seen as lying with the patient. The research problem is then to find out what there is about the patient that makes him a defaulter. This is a view of the problem from the point of view of the medical profession. An alternative approach from the perspective of the patient is suggested. The focus is then on the social context in which illnesses are lived and treatments used. A more active view patients is entailed in which patients have expectations of the doctor, evaluate the doctor's actions, and are able to make their own treatment decisions. Rather than "defaulting" being found in certain types of individuals, almost anyone can be a "defaulter" at some time or another.