Ask physicians and nurses about their biggest clinical problems and non-compliant patients will likely be near the top of the list.
And why should we care? Because non-compliant patients are huge cost drivers.
Ezekiel Emanuel (MD, PhD, NIH) estimates that one-third of U.S. health care costs are driven by diabetes, and we know a lot about controlling diabetes, but it is very dependent on the patient being compliant with diet and medications. We don't do so well on this. Ask a nurse.
Is there something about Americans that make us less compliant than we should be? Is our consumer culture a bad place to promote health? Is there not enough information? Are we stressed into non-compliance?
Whatever the reason, it is very costly for all of us.