4 strategies for patients who ignore medical advice

With more health information available than ever before, patients become more willing to challenge their physicians' expertise, turning allies into antagonists.

The greatest barrier to getting patients to listen to the wisdom and experience of a veteran physician over the many online sources of various quality is confirmation bias, according to Gregory A. Hood, M.D., in an article for Medscape. “The confusion of preexisting patient conclusions and the use of self-validating search engine searches as a substitute for either research or offered wisdom and experience are seemingly on the rise,” he writes.

Findings such as those in a recent study showing more than one in 5 patients receive misdiagnoses from primary care providers further erode public trust, helping confirmation bias continue to overwhelm scientific evidence, with the anti-vaccination movement being a prime example.

RELATED: More than 20% of patients misdiagnosed by primary care providers, Mayo Clinic study finds

For physicians facing an uphill battle with a patient who refuses their advice, Hood suggests some possible solutions:

• Generate a menu of responses to situations that frequently pit patients against a preferred course of treatment. Hood stresses that these explanations should be updated frequently, based upon solid evidence, and short. For physicians who find themselves repeating the same advice over and over, consider a one-page handout.
• Because most patients advocate for themselves, and patient engagement is an important element of their care, consider whether the patient’s wishes may offer an alternative path, even if it isn’t necessarily what you would have chosen in the first place.
• If patients do opt for a care plan that differs from what you would consider optimal, physicians should be open about why they believe that plan will or will not work. In cases where the plan falls short, Hood advises physicians to offer patients advice about additional steps they might take.
• Don’t be afraid to offer patients the opportunity to seek a second opinion.