Not all patient stories make good adherence stories

There are legions of patient stories out there — just take a look at the many chatlines, blogs, tweets and facebook posts by patients. Some complain about their treatment, some worry about their disease, some feel better, some don’t like their doctor …

While these patient dialogues and interactions may help, they may also not be helpful — or, in fact, they may even be harmful.

As Melanie Green, a social psychologist at the University of North Carolina at Chapel Hill, explains:

Research suggests that people are not very good at filtering out which stories they should be using. It’s all about plausibility. Think about whether this is a typical case. Is this person similar to you on things that are relevant? Do they have a similar health history? Similar age? Any of those things can make a difference.

According to Dr. Ben S. Gerber, an associate professor of medicine at the University of Illinois at Chicago, stories can be medically helpful if they provide:

  • basic information
  • emotional support
  • model behavior
  • “a more realistic sense of the good and bad than the doctor does”.

In short, not all patient stories make good adherence stories.

Boxcutters Gem #525 (corollary to 523) – Just because it’s a story told by a patient doesn’t make it an adherence story.

3 Responses to “Not all patient stories make good adherence stories”
  1. Cheryl Handy says:

    Maybe the purpose of the “patient story” is just to provide a warning of unethical behavior or poor medical practice by injured patients. How on Earth can that be a bad thing?

    Injured patients are told that “suing” is a bad thing. Suppose a patient is actually injured and the physician or surgeon is not accountable. What alternative does the patient have?

    • Michael Wong says:

      Very true, Cheryl. If a patient gets hurt, either from the doctor or from the medication, that’s a story about perhaps needing to find another doctor or another medication. Although a very valuable story, it’s not one to help other patients stay on their medication.

  2. Cheryl Handy says:

    With respect to drug adherence, the patient should always be encouraged to communicate directly with the prescribing physician. Any patient who relies on blogs, tweets for medication adherence is a noncompliant patient.

    I believe that patients who make decisions about medication adherence on blogs, tweets, neighbors are looking for a reason to stop the taking the medication. Then we are back at discussing “why” the patient wants to stop taking the medication. Side effects? Expense? It is the physician’s responsibility to ascertain why the patient does not want to take the medication.

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