Patient Compliance and the Role of the Expert

The failure of patients to follow recommendations made to them by health experts usually represents a hazard to the patient's health, a waste of health resources, and a source of frustration to the health expert. Many studies of such failure lead to the conclusion that every patient should be considered as potentially "non-compliant." The most promising site for intervention is in the expert-patient interaction. Viewing compliance as a property of the transaction between expert and client, it is appropriate to see the responsibility for establishing compliance as shared between expert and client. From this viewpoint, several models of the expert-client relationship are reviewed. Three areas of responsibility can be assigned to experts—exploring the individual patient's situation fully; anticipating the patient's difficulties in following recommendations; and communicating information in a way that will maximize its effectiveness. Recognition of these responsibilities will have numerous consequences for those who teach health professionals and for psychologists engaged in the study of communication processes.