Working with the Noncompliant Patient

For the Fall 2003 issue of The Permanente Journal,1 I wrote an article entitled “Understanding Noncompliant Behavior: Definitions and Causes” (xnet.kp.org/per-manentejournal/fall03/behavior.html). It discussed the various underlying causes of more seriously noncompliant behavior (NCB) with the goal of understanding that noncompliance is not a unitary entity but has a differential diagnosis. Use of this differential diagnosis, it was stated, could lead to more effectively working with the noncompliant patient. The goal of this article is to offer the practicing clinician tools for working with the noncompliant patient.