Do you ever feel like you and your diabetes providers are on different planets, playing two totally different games? You hear them speaking, but the words fall short. They are saying things that “should” be helpful, but somehow it misses the mark. It feels off. Could it be that what they want for you gets lost in translation? It’s a great question to explore.
The Standard – Patient Compliance
In the clinical world, if you don’t follow your doctor’s orders you are said to be ‘non-compliant“. Meaning you did not comply with the prescribed plan of care. It can feel like “Bad Patient”. Not a label anyone wants. You are a loser by implication.
So, it stands to reason, that doing what your doctor wants you to do will get you flagged as “compliant”, a “Good patient”. You get the gold star! They’ll keep writing your prescriptions! You are a winner!
But are you? There is an assumed expectation that being compliant is desired, good, and what you “should” do. However, compliance has its own dark lining.
Compliance is an external measure of your behavior or your actions. Did you do the thing – yes or no? It’s a judgement of your performance. It’s a very black and white assessment with little wiggle room. Compliance needs perfection. To be measured, all the variables must be clearly defined. And that means limited choices. Without choices, you may feel trapped, frustrated, and hopeless. It’s a very narrow path.
Then, when diabetes throws you a curveball at you (and it will), you are stuck empty handed on this narrow lane with an empty bag of tricks. And when you fail to meet the mark (and you will), shame and guilt rear their ugly heads dashing your self-confidence. And you sit in your provider’s office thinking “They have no idea what this is like. This isn’t helping!”
Is that really what your diabetes providers have in mind for you? Goodness let’s hope not!
An Alternative – Resilient People with Diabetes
Here is my take (and a few other smart diabetes researchers 1 –2 –3 ). Resilience is the key to an optimized diabetes plan of care. It’s the OPPOSITE of compliance in my humble opinion.
First, resilience is an inner state. It is a way to “be” not something to “do”. It’s all about possibility and options, unlike the rigidity of compliance. It’s a world view that helps you navigate the unexpected things life will throw at you. It is anything but judgement, and fosters a “get back up and try again” mentality.
Whereas compliance requires a belief in another’s rules and expectations, resilience only requires YOUR permission to become curious, modify an approach, find a new perspective, or decide that your last “failure” taught you a valuable lesson for next time. It’s an inside out perspective that is empowering and compounds with time.
I have failed to be compliant numerous times. But when I set my sights on being resilient instead of perfect, the game changed. And my diabetes improved dramatically. I may not have perfect blood sugars, eat perfectly, remember every fingerstick or bolus exactly when I should. Nope. Not at all. But I have a resilient outlook that allows me to be nimble, to adjust, to modify, to find grace in my failures, to not beat myself up, to keep on going, to be curious and to love myself enough to do the work.
So, I know my answer, but I will pose this question to all Diabetes Providers, “Do you want patients who are more compliant or patients who are more resilient?”
Chime in! Tell me your thoughts. What is your experience? What is the path to improved outcomes and better health? Compliance or Resilience?
It’s a conversation we need to have!
I *so* agree with this. I’m lucky to have an endo who’s supportive and resourceful. Perhaps endos get burned out, too; I don’t know, but if they’re not doing anything but making you feel guilty, time to move on to the next one!
Yep, I am sure dealing with all the permutations of diabetes every day can be daunting! Maybe they just need a little reminder they are appreciated and we are all on the same team.
Heck – maybe they should take my course! Burnout happens to the best of us!