Monday, August 28, 2017

Science is Marvelous…sometimes

A group of researchers has discovered that people will do things when they are rewarded.

The headline that caught my attention this morning in my daily medical information was this:


The article went on to describe an experiment wherein low income people were given cash incentives ranging from $0 to $50 and they discovered that “(s)ubjects in the $50 and $25 incentive groups were more likely to see a primary care provider (77 percent and 74 percent, respectively) compared to the $0 group (68 percent). In the control group, 61 percent received care.”

Okay, we got them to the doctor (with a bribe). Now what are we going to do to make sure that they follow through on their doctor’s instructions? The issue is not getting them to the doctor, but making sure that they follow the directions to stay healthy.

Over the course of my 20-year medical career, both as a mid-level provider and as an Administrator, the most frustrating part of medical care is the non-compliant patient. My first job out of Graduate School as a newly minted Social Worker was working with non-compliant Adolescent Type 1 Diabetics. The facility where I worked was created by a doctor who was tired of seeing his patients ending up in the ER for blood sugar issues, when it could be so easily controlled.

The easy part is getting them to the doctor, the hard part is having them follow their treatment plan.

So let's follow the the logic of this study: patients will only go to a Primary Care Doctor if they are externally rewarded, and the prospect of getting medical care to help them feel better is not incentive enough. Then what, pray tell, will motivate them to follow directions to stay healthy?
  • A c-note for every 10 lbs the morbidly obese patient loses?
  • $25.00 every time a Diabetic tests their sugar?
  • How about $150.00 if that COPD patient uses their inhaler every day?
With enough “incentive,”all patients will be motivated to be compliant.

Next week’s big scientific breakthrough: Water is wet.
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