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It sounds like a good idea, despite the doctors being that way.
As someone who’s only ever been on the patient side of things, what is concordance in the medical sense here? What sets it apart from compliance and adherence?
Warning I’m going to be simplifying things a lot with regards to medical treatment. Medical treatment obviously refers to more than just taking a pill or doing an exercise, I’m trying to keep this light and as widely applicable as possible and you can feel free to substitute any intervention as necessary and you can obviously ask me to clarify or question or correct my wording. Also a lot of the wording may seem like I’m talking about non chronic situations but it applies equally.
Compliance refers to how close a patient adheres to the agenda set by the medical professional. It’s whether you take your medication as prescribed by your doctor, whether you do the rehabilitation as told, whether you do all the exercises your physio showed you. If you aren’t compliant you are not doing as you are told, if you are compliant you do as you are asked.
Adherence is active participation in an agenda. So if based on guidance from a medical professional you make lifestyle changes and stick to them even when not watched you are adherent. Adherence is you making a habit of taking your pills, it’s making and following an exercise plan, etc.
So in other words if you don’t take a pill your doctor is telling you to take you are non-compliant, if you haven’t made a habit of taking your pills as part of your regimen you are non-adherent.
Concordance is the agreement between a patient and a medical professional with regards to their agenda and their understanding of their own disease process (uhh i forget what the english name for that is). It refers in totality to the process of aligning the doctors desired agenda and the patients desired agenda, the level to which the two are in alignment and the patients engagement with the plan set forth. So in order to have concordance a medical professional must take into account the physical, social and psychological premises under which you exist and help you reach a treatment plan and a common agenda. Conversely you must as a patient be an active part of the planning of your treatment plan, advocate for your needs, and be honest about your ability to follow any plan and vulnerable enough to take it into account when making a plan and in your discussions with a healthcare professional.
So if you are actively changing your schedule to accommodate a treatment plan you think is ridiculous and which does not account for you as a person outside of the immediate list of symptoms you may be adherent, but there is no concordance. But if you helped set your schedule and as a result feel engaged in your own treatment and wish to follow it, there is concordance.
Some people point out that the framing of adherence and concordance puts a lot of responsibility on patients rather than doctors, and that it may be a way to avoid responsibility for the outcome of patient care. Others point out that a compliance based model limits patient autonomy which is supposed to be a core value of patient care and is likely to be less effacacious.
First of all, thank you so much for the explanation, I don’t think I’ve ever had anyone explain “medical talk” this explicitly to me.
Secondly, you are really good at explaining these things even though English isn’t your native language. You’re doing great both linguistically and medically.
And finally, I totally see now why you would be running into a brick wall with these definitions and how doctors don’t take that responsibility seriously enough. It’s a difficult topic, but I think a comic could really help explain this stuff better. You should give it a try
If you ever have any questions about jargon I’m always up for explaining if I can, I think patient communication is super important and I think as patient you have the right to know what’s going on (But I can’t provide any kind of medical assistance through the internet, both because I am unqualified to diagnose anything, and because it would be irresponsible even if I were qualified.). Now I’m making a summer project out of learning to draw better, even if I never become good enough to draw that comic it at least gives me something to do.
I appreciate the offer, thank you! And I’ll be sure to ask a local doctor for medical advice.
By the end of summer you’re probably good enough to draw the compliance-adherence-concordance comic, you’ll see