Although practicing physicians are skilled in presenting their recommendations in psychosocial and vocational areas, these recommendations frequently are distorted and are rejected by patients. In an investigation conducted by the Marquette University Cardiac Work Classification Unit,1 one quarter of the patients rejected psychosocial recommendations, and one third of the patients rejected vocational recommendations. Conversely, the investigators noted a high degree of compliance with purely medical recommendations.
Is a stubborn or contrary nature in the patient responsible for rejecting medical advice? Probably not. More subtle psychological factors cause the patient to misperceive what he has been told.
Recently, Hellmuth2 reported on a study designed to find evidence of perceptual distortion of a physician's advice in a series of successive cardiac patients. The procedure involved tape-recording the physician's routine recommendations to the patient. Immediately following the first taping, a second tape was made of a separate interview between the same
DISTORTION OF CLINICAL RECOMMENDATIONS. JAMA. 1966;197(10):810–811. doi:10.1001/jama.1966.03110100118030
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