Noncompliance

I think one of the most frustrating things to deal with in the medical profession is noncompliance amongst patients.

I can understand when patients are not compliant with diet and exercise regimens or with quitting smoking.  Even though, in many cases, those are the bigger problems and ones that most need getting fixed, I can appreciate that those aspects of a person's life are profoundly hard to change.  As someone who works hard to find time to exercise and hates the most vegetables but forces them down anyway, I find myself personally frustrated with patients that won't do the basics to improve their diet and exercise, but at least I get it.  Quitting smoking and losing weight are statistically two of the hardest things in the entire world to do.

Seriously, it is incredibly difficult to quit smoking.  I couldn't find any really good numbers on long term quit rates over the life time of a smoker, but this site offered that any given attempt will have a success rate of 4-7%, and with medicines this may go up to 25% for 6 month abstinence (note: this is not lifetime abstinence).  By contrast, 29% of attempts to climb Mount Everest are successful.

Take a moment to let that sink in.

Don't get me wrong, I want to beat my head into and then through my desk every time I meet a patient who is unwilling to meaningfully change their diet/exercise/smoker status, but I get it.  Those are really, really, really hard things to do.

Taking a pill every day is not.  Taking a pill every day is a really, really easy thing to do.  There are cases when it is not - the elderly patient who is taking fifteen medicines and can't keep them straight; folks with dementia; patients with brain trauma that causes memory impairment; etc.  But in the vast majority of cases, where a patient needs one or two blood pressure pills and maybe a statin, it is really, really easy to take the pill every day and enjoy a large and very statistically meaningful mortality and morbidity (quality of life) benefit.

And that's why non-compliant patients frustrate the hell out of me.