Patient Compliance

What is patient compliance; and why is it so important? Patient compliance is directly responsible for our office success rate of 90%; as it is the ‘negative people,’ who don’t follow through or continue treatment, whose results do not get counted in the first place. When it comes to ‘success’ in the field of neuropathy, it is only the patients who are truly motivated to succeed who will do so. If someone is not willing to ‘help themselves,’ we tend to ask them to leave our office. Isn’t this rather harsh? Not really. Patients whom are unwilling to help themselves, cannot be helped by us either; and treating them when we know treatment isn’t going to help, is not only a waste of time and the patients money, but can only give us a bad reputation! Simply put, patient compliance is the ‘patient complying with treatment plans;’ such as keeping appointment schedules, and following directives such as taking vitamins, nutrients, changing their diets, exercise, home sensorimotor stimulation and etc. which has been prescribed for their particular type and symptoms of neuropathy.

In actuality, only 50% of those who walk in our doors complete or even start treatment; as, unfortunately, they are simply not willing to make changes in their lives which will help… such as exercise, better diet or stop smoking. Sure, it can be for a number of reasons as well… financial, time, distance and etc., but the BIG issue is compliance – they simply, do not wish to make any changes or participate in their own recovery!

I will give my patients several items or directives to use or follow at home. When they come into my office for treatment, however, we end up with a conversation something like this:

            “So, did you do your Sensorimotor Exercises this week?”

            “No.”

            “How about taking your B Vitamins and Omega 3’s?”

            “No.”

            “Did you do your Stretching Exercises?”

            “No.”

            “How about record your results?”

            “No.”

            “You know, you are not going to get any better if you don’t follow my recommendations at home!”

I generally hear back:

            “Well, you just said it… they are ‘recommendations.’ I shouldn’t have to follow them if I don’t want to. Besides, I’m                            paying YOU to fix my neuropathy…, not to do it myself!”

If the patient doesn’t at least attempt to meet the neuropathist ‘half way’ in their own treatment, then they are wasting not only their money and time, but the neuropathists time as well! Unfortunately, I can’t help anyone who is unwilling to help them self.

Think of it this way, if a doctor prescribes a medication for a condition like blood pressure, but the patient is not willing to take that medication, the blood pressure is not going to improve no matter how much both the doctor and the patient might like it to. The patient has to comply and actually INGEST the blood pressure medication before it will work! Unfortunately, I have seen way too many patients unwilling to do this! I don’t know how they expect to ‘get better,’ if they are not willing to follow the direction/recommendations of the doctor and/or the neuropathist.

So, if we have a “90%” success rate, who are the 10% treatment doesn’t work on? The highest number of people, unfortunately, are the aged. The longer one might have neuropathy, the harder it is to reverse nerve damage.  We have seen, however, patients as old as 92, whom have had peripheral neuropathy for as long as 57 years achieve substantial reductions of symptoms. Others, tend to be the truly ‘idiopathic’ patients; who we don’t have any reason for their neuropathies… and they simply don’t get better.  Others, it can be from injury or trauma to the back, for example. If the back cannot be repaired, the neuropathy cannot either.

Unfortunately, the next largest number of people, are the ones whom are ‘self medicating;’ meaning, they are drug addicts or alcoholics.  One man, for example, has been a faithful, loyal patient of mine for years; we have substantially repaired his feet – but, his hands are another matter.  Once ‘balanced,’ he can easily go one or two months between treatments. His hands, however, see very little change. One reason, is that he has arthritis in his hands which complicates the neuropathy.  Treatments actually help his arthritis substantially; but when it comes to his peripheral neuropathy, he cannot make any headway at all.  His problem?  He is an alcoholic and does ‘recreational’ drugs.  By ‘self-medicating’ with alcohol and drugs, he counteracts any efforts we make with Neuromuscular Stimulation.

Of course, we have made the recommendation to him that he ‘quit’ his drinking and drug use; but, even with all the edema, pain, numbness and burning he experiences in his hands and fingers, nor, the fact that he has had several DUI’s while driving, he is simply not motivated enough to work on his addiction. Drug and alcohol addiction is very difficult to reverse; but it is possible… but one must WANT to quit before actually doing it.

I have told this man, what I have told others like him; “I’m not your Mama, so I am not going to lecture you! But, when you are ready to quit drinking – which you know is what is, mainly, causing your neuropathy – then I am willing to help you at that time.” What can we do for drug or alcohol addiction? Generally, I like to refer to a specialized program to help with such issues. But, if nothing else, we use a CES device (Cranial Electrotherapy Stimulation). Placed on a specific area of the ear, it works like acupuncture to cut down on the ‘cravings’ by the alcoholic or drug addict.

This treatment works so well, that in our town, one judge in particular, has told some of my patients; “either purchase and use the device and seek treatment as well, or go to jail!” Most, of course, will see us for treatment and purchase a CES device as well. Again, this is considered, ‘patient compliance;’ as the patient is motivated enough to continue treatment or purchase equipment. And, “Yes,” in this case, the motivation is ‘legal’ rather than medical… but, “whatever works,” in my opinion!

More on Cranial Electrotherapy Stimulation in another post.

 

 

Next Blog, Treatment.

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One response to “Patient Compliance

  1. Pingback: Berg Balance Testing | Ask the Neuropathist

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