Abstracto

Patients nonadherence and doctors clinical inertia: two faces of medical irrationality

Gerard Reach

Patients’ nonadherence and doctors’ clinical inertia, two phenomena jeopardizing the efficiency of care, represent two faces of ‘medical irrationality’. It often happens that patients or their doctors do not do what they know they should. I propose that common mechanisms are involved, including a failure to consider the future; an innate aversion for losses; the effect of emotions, especially fear and anticipated regret and the desire to protect freedom. Recognizing medical irrationality as a psychological reality – both patients and doctors are human beings – and clarifying its mechanisms have important practical and ethical implications: it shapes the format of sound patient education and good practice guidelines, and leads to the promotion of a patient, or better, of a person-centered, medicine.