Let’s Talk About “Noncompliant”

A doctor doodle hands a name tag that says “noncompliant” to their patient. The patient doodle looks puzzled.

Here at We ❤️ Health Literacy HQ, we’re fond of rethinking terms that have been hanging around for a while — but, for one reason or another, aren’t getting the job done anymore. Today, we’re pondering a term that often comes up in health care: “noncompliant.”

Health care providers and other professionals may label a patient “noncompliant” if the patient isn’t following instructions or taking steps to care for their health at home (like taking medicine consistently or making changes to their eating habits). Well, we think it’s time to ditch “noncompliant,” whether you’re talking to consumers or professionals.

First, “noncompliant” paints people as rulebreakers. The word reminds us of a student getting sent to the principal’s office — or someone who has “failed to comply” with a judge’s order. It sets up an us-vs.-them dynamic, painting doctors as the authority figure and “noncompliant” patients as people who choose not to follow their simple instructions. This dynamic brings shame into the conversation — and we know, dear readers, that shame isn’t an effective tool for behavior change.

“Noncompliant” also fails to acknowledge the many reasons why people may struggle to follow health advice. Sure, it’s possible that some people just don’t like being told what to do. But we’d argue that many more people “fail to comply” for reasons outside their control. For example, if a doctor tells their patient to eat more fruits and veggies, but the patient lives in a food desert, they’re going to have a hard time finding those healthy options.

Or let’s say a doctor tells a patient who’s struggling with depression to get more physical activity. A 15-minute walk might boost the patient’s mood, but when you’re depressed, it can feel impossible to leave the couch. Similarly, many people with ADHD and other neurological conditions struggle with executive function— basically, the skills you need to plan ahead and stick to your plan. AND lest we forget that the instructions may have been so convoluted and jargon-y that the patient wasn’t clear on what they were supposed to do in the first place!

The way we talk about people influences how we treat them. Taking “noncompliant” out of our vocabulary reminds us to look at the whole picture, consider how social determinants of health play a role in individual well-being, and build respectful relationships with our audiences. Now that’s something we can get behind.

The bottom line: We think it’s time to ditch “noncompliant,” whether you’re talking to consumers or professionals.

Tweet about it: This week, @CommunicateHlth explores why it’s time to ditch “noncompliant,” whether you’re talking to consumers or professionals: https://bit.ly/45CJL1H #HealthComm #HealthLiteracy


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