This is a major question that deserves more discussion and analysis. There is no secret that our health care system is going through a crisis and the available resources are diminishing. We have been used to blaming physicians and the health care system for higher costs and lower quality of care, but what about the responsibility of the patients in this respect?
Some may argue that patients are not really at fault when the desired outcomes are not achieved, patients are purely lay people who are totally dependent on the advice and management of their doctors. However, if they understood more everything could be different. This logic relies on the assumption that well educated and knowledgeable patients will be compliant and follow their doctor’s instructions and suggestions faithfully. But we know from real life that this assumption is nothing more than wishful thinking.
How should society treat patients who are well educated and know what to do but are still not compliant and continue going through one complication after another?
Should these patients be required to have higher co-payments or accept more financial risks related to their care?
This question will probably need to be discussed for years to come. Identifying these patients may be the easiest part but implementing the changes would be difficult. I may still be a dreamer but I believe that incentives granted to patients and physicians for an uninterrupted and continuous progress could make a significant difference. A combination of negative and positive enforcements could also be studied. We currently have some incentives awarded to patients but these incentives are centered on superficial changes and not on real fundamental ones.