Working with Patients Who Do Not Follow the Treatment Plan 

Patients who do not follow the treatment plan may become high liability risks because their behavior often exacerbates existing health problems, which can lead to negative outcomes. These steps can help improve patient compliance when patients refuse to follow your recommendations:

  • Explain the risks of not following treatment recommendations.
  • Ask if they have any questions.
  • Verify that they fully understand what you have told them by having them repeat it back to you.
  • Encourage them to be responsible for monitoring an aspect of their care—such as blood sugar levels, weight, or blood pressure—and have them record it and bring it to you.
  • Write down your care instructions and give it to them. (Be sure to also file a copy in the medical record.)
  • Follow up to see if they have been doing what is required.
  • If they have not been following the care plan, ask why and see if adjustments can be made. For example, maybe they could not afford the prescribed medication, and there is a less expensive alternative available. 
  • If necessary, enlist family members or significant people in their living circumstances to encourage patient compliance.
  • Be persistent. Sometimes patients need to be told the same thing more than once in order to understand and comply.
  • Thoroughly document all of these steps in the medical record so you can demonstrate that you have done all you could to encourage compliance.

The guidelines suggested here are not rules, do not constitute legal advice, and do not ensure a successful outcome. The ultimate decision regarding the appropriateness of any treatment must be made by each healthcare provider in light of all circumstances prevailing in the individual situation and in accordance with the laws of the jurisdiction in which the care is rendered.

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