One of the risks of communicating is that sometimes we don't. We use words and terms that we understand, but that clarity
may not extend to everyone in the room. Veterinarians are not exempt from this problem. We often use words that are intended
to convey a particular meaning, and sometimes two words convey similar intentions. The devil is in the details, and the differences
are in the subtleties.
Compliance vs. adherence
One ongoing concern is the reality that medications are frequently not taken as prescribed. Medical care professionals—whether
physicians or veterinarians—look primarily to patients and clients as the reason that this occurs. We used to apply the term
"compliance" to the fact that clients weren't giving their pets prescribed drugs as recommended. We used the word when there
was a willful refusal to follow instructions: "I told you what to do, and you didn't do it!"
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Increasingly, the term "compliance" refers to the medical team's failure to comply with making a recommendation that it has
agreed to support. If our standard of care is year-round parasite prevention or quality nutritional guidelines, why are we
not complying with our own policy to advocate for what is best for the pet? Just how have we decided which of our clients
doesn't deserve to hear what we believe is best?
Perhaps a better word is "adherence." If we're consistent or compliant with our advocacy, more pet owners will undoubtedly
accept our recommendations. Unfortunately, the job isn't finished there. Clients may agree with the best of intentions to
medicate their pets (or, on the human healthcare side, themselves), but their adherence to the plan is low. Whether we're
talking about heartworm preventive for their dog or maintaining control of their own diabetes, adherence is generally less
than 50 percent. Compound that with the fact that our compliance with advocating for a particular approach is about 50 percent,
and we're down to about 25 percent of our patients getting the care we believe is best.