Denial: The diabetic who refuses to check her blood sugar, who says"But I am really healthy other than my diabetes" and then comes to see me because she is peeing all the time. She is sure it must be a bladder infection, or a problem with her bladder. It can't be that her blood sugar is elevated and that makes her kidney's overproduce urine in an attempt to lower her blood sugar. Her normal urine culture and large amounts of sugar in her urine don't convince her. The normal bladder exam doesn't convince her. She wants me to fix her problem. And gets upset when I say the way to fix it is to get her blood sugar under control. The teenager who doesn't want to believe she has placed herself at risk for an STD and doesn't want tested or to use condoms. And then cries six months later when I say she has Chlamydia or even worse, an STD I have no cure for.
is a common complaint...but they didn't take the medicine like they were instructed. You can't take a 10 day antibiotic for one day and expect it to cure your severe bladder infection. If you want to get better, you should probably come to your appointments. If you aren't getting better, you should probably come to your appointments so we can try a different treatment.
Lack of personal responsibility: The problems they are having are not their fault. They tell me it is my fault. Or it is their parents or spouses fault. I see a huge lack of willingness to accept personal responsibility for their own health. I see many patients who want an instant fix for their problems. They don't want to hear that it will take effort. They want instant cures, something that doesn't inconvenience them, isn't uncomfortable and that requires no effort on their part. If they didn't take the medicine, it isn't their fault. If they didn't go get a test done, it was because it wasn't convenient enough. Or the patient who "has to be seen right away" but can't make any of the appointment times we offer. Then tell us we are refusing them access to care.
What do I see in patients who do get better? Honesty, personal responsibility, and persistence. But that is a blog for another time...