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You have no idea how many patients I see that are non-compliant because the provider did not take the time to take all these factors into consideration. When I call the MD, their response is "Oh , they're non-compliant". But curious enough after seeing the patient and looking at her situation from a wholistic perspective, it makes sense why she doesn't comply with tx: Pt is $50,000 in debt r/t to medical expenses, can't afford the meds, has no social support, and although she was dx with diabetes (among others) for 5 years, she didn't know of the complications of untreated DM (whether the dr didn't tell her, or quite possibly no one followed up with her to see that she understands). Per pt report she stated that she felt like no one took the time to listen to her, just prescribed more and more meds.

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Hi, I was reading your post on the discussion of PA's and NP's from Sept 09. Although the thread is closed, just wanted to comment from a home care RN perspective. What I've found is that when the MD/PA/NP take the time to explain the dx, tx and viewing the patient's situation in a wholistic way (ie financial resources, family situation, etc) there is an increase in pt compliance with tx.

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...Just thinking that within the thread where the debate was NP vs PA and "patient satisfaction" and the fact that "patients don't know what good medical care is" maybe TX COMPLIANCE would be a good variable to test as to which mid-level practitioner (I would even add the MD's) has better patient outcomes in terms of tx compliance. Yes, I agree that dx and tx is important for practitioners but what good is it if the pt is non-compliant. And I also agree that pt compliance has multiple variables but what I've come across in home care is just poor communication and hurried dr visits b/t pt and provider (MD in majority of my home care cases). Anyway, just my 2 cents.