They Don’t Always Do What They Say, and Sometimes We Don’t Either

Abstract

To the Editor: The following observation prompted us to write this letter. As part of a research study, we have been providing automatic blood pressure monitors and hypertension education to underserved patients. Almost across the board, those enrolled have verbally consented that they would increase physical activity, assess blood pressures at home, and change diets. However, we noted several participants who have not changed their diets or assessed their blood pressures as promised. How common is it for people to verbally agree to do something and then not do it? It’s probably more common than we think. Do we physicians really follow the guidelines that we tout to our patients? Do we watch our salt intake and increase our physical activity? Do we take our medicines, or do we even seek medical attention for problems we may have? What are we communicating to our students? Are students taking us less seriously when they see behavior inconsistent with what we are teaching? We may be losing credibility when they “hear” us say one thing and they “see” us do another. This is not just an issue of students’ perceptions, as our patients probably observe the same thing. Are patients in our study jaded because our body mass indices fall outside the normal range, or is this just what folks tend to do—“teach” it and not “live” it? What about adherence? Are we sending nonverbal messages to our patients about how we really feel about behavioral changes? The reality of the matter is that we doctors are human too. Just because we have completed medical training and we “know” what we should do and we understand the consequences of nonadherence doesn’t mean that we are always compliant. That said, we should try to do a better job demonstrating adherence and behavioral change for our patients and our students. It may just improve health outcomes and help create more compassionate and understanding physicians. Kendall M. Campbell, MD Associate professor, Department of Family Medicine and Rural Health, Florida State University College of Medicine, Tallahassee, Florida; [email protected] Robert Solomon First-year medical student, Florida State University College of Medicine, Tallahassee, Florida.