Many patients I saw this month had financial difficulties that prevented them from receiving the textbook treatments for their disease. It was often necessary to look at the Walmart $4 prescription list to choose medications that would be feasible for a patient to purchase. The five minutes it took to figure out which medications would fit a patient’s financial needs made treatment possible. Sometimes though, patients had multiple comorbidities, so even the $4 medications would add up and a patient was left deciding which medication was the “least important.” Before I jumped to labeling a patient as noncompliant, it was necessary to figure out WHY they hadn’t been taking their medication. After hearing that paying for prescriptions took a huge percentage of a patient’s monthly income, I suddenly became much more understanding and less judgmental of their “noncompliance.” Furthermore, some patients had difficulty finding transportation to their appointments or figuring out how to get childcare. It is easy to tell a patient to come back to do fasting labs or to follow up in two weeks without recognizing how big of a request that may be. Socioeconomic status also affects a patient’s ability to follow certain diets, especially when they have to provide for the needs of children. It is imperative to be aware of these issues and to be ready to counsel patients on less expensive ways of achieving their goals.
Education level also affects the way a patient responds to their disease or treatment plan. It is easy to take for granted that a patient would understand what kind of diet they should follow as a diabetic, when a patient may think they only need to avoid candy or coke. Also, certain conditions carry stigmas in different cultures, so the way information is presented to a patient with those beliefs is so important. I’ve learned that cultural competence, socioeconomic awareness, and being educated on social issues are going to always be a big part of my career. I need to work hard to learn as much as I can about the community I practice in and the resources available around me."