Patients Come to You for Recommendations

A common frustration among new graduates, younger clinicians, and even seasoned professionals is dealing with patients who don’t follow the prescribed plan. It’s easy to fall into a cycle of frustration when patients don’t do what you “tell” them to do, leading to venting sessions with colleagues and tension in the clinic.

But what if you shifted your perspective? Instead of expecting patients to follow every instruction perfectly, recognize that they are coming to you for your expertise and recommendations—not strict commands. This simple mindset shift can significantly reduce negativity and frustration.

Change Your Frame of Mind

At the core, patients seek out your guidance because they have a problem they want to solve. Their issue could be an injury, pain, or a functional limitation that prevents them from reaching their goals. Your role is to offer informed recommendations based on your education, experience, and understanding of their specific condition.

Remember:

• Your job is to provide clear, evidence-based recommendations.

• The patient’s job is to make their own decisions based on the information you provide.

Some patients will follow your advice closely, while others may not. And that’s okay. Each person has their own unique set of factors influencing their behavior—medical history, past experiences, motivation levels, support systems, lifestyle, and even personal beliefs. The sooner you accept this, the more comfortable you’ll feel in your role as an advisor rather than a commander.

Real-Life Variability

Having worked in diverse settings—from rural Virginia and California to urban clinics in Chicago and San Francisco—I’ve seen firsthand how different environments shape patient behavior. In rural areas, I worked with patients dealing with bedsores due to immobility, while in big cities, I treated professional athletes, recreational runners, and active seniors.

Regardless of the setting, I’ve encountered patients who diligently followed my recommendations and others who disregarded them entirely. This variability is a natural part of patient care, and understanding it helps you remain grounded and focused on providing the best possible guidance.

Ask “Why?”

When a patient isn’t adhering to your recommendations, don’t hesitate to ask a simple yet powerful question: “Why?” Understanding the reasons behind non-adherence can offer valuable insights and help you adjust your approach for better outcomes.

For example, imagine you give a patient 10 exercises as part of a home program. Over the next three weeks, they return without having done any of them. If you don’t ask why, you miss an opportunity to learn and improve. However, if you do ask, you might discover that 10 exercises felt overwhelming. By pivoting and reducing the list to three manageable exercises, you increase the likelihood of adherence. The patient comes back the following week having done the exercises, and both of you feel more successful.

Key Takeaways

1. Shift your mindset: Patients come to you for recommendations, not orders.

2. Accept variability: Each patient will respond differently based on their unique circumstances.

3. Stay consistent: Always give your best recommendations, even if you know not every patient will follow them.

4. Communicate openly: When patients don’t follow your advice, ask why and adjust accordingly.

Ultimately, the goal is to empower your patients to make informed decisions. By maintaining a positive, flexible approach and focusing on communication, you can build stronger relationships and foster better outcomes—even when patients don’t follow your advice to the letter.