They told us in medical school that in modern times, patients have much less regard for what the doctor says, and are less likely to follow instructions or be compliant with medications, than fifty years ago.

With that expectation, I’m always amazed when people about to be discharged after surgery inquire scrupulously into what they are “allowed” to eat, drink, walk, climb, carry, etc. Often my first thought is, “How should I know, and why should I be setting you limits on that?” Nevertheless, it seems best to give some instructions when asked. For a doctor to say “I don’t know” is discouraged. And of course there are the common-sense rules like, don’t drive while taking narcotic pain medications (which is also the rule that people will argue about the most, at least while talking to us in the hospital).

So I wonder, when we give specific instructions about diet (one area of discharge orders that surgeons actually do care about, as opposed perhaps to adjusting the precise dosage of blood pressure medications), how much people really follow them. Advice like, don’t eat red meat for a few weeks; don’t eat solid food for the next week; don’t drink fruit juice (high in sugar, low in nutritional value), must be difficult to follow.

They told us in medical school that only 50% of patients will actually take medications in anything resembling the prescribed manner. I wonder whether surgical patients are more likely to follow instructions, since they probably feel sicker than people being treated for diabetes or high blood pressure, and since our medications and prescriptions (antibiotics) only cover a few weeks at most.

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