Free patients

In practice we see a lot of patients that we know at a personal level and treat them without any consulting fees. We spend more time explaining to them about the disease and clarifying their doubts then the usual run of the mill patients. But these are the people who become a failure to us. Failure in that, most of them do not comply with the advises as much as patients who wait their turn to see us and pay out of their pocket for the consultation. (Of course this applies to places like where i live where there is medical insurance is not popular). This is sad because the people who you really want to take care are the people who end up getting the least care. I have along list of such patients – a relative who is obese and constantly has under-controlled blood pressure, a colleague’s wife who has diabetes and gone to develop albuminuria, i can keep on making a long list. But the underlying theme in all these patients is, they do not pay for their consultation and do not comply. Is it because they do not wait for an hour in the waiting room (Because i see them right away) make them think that the doctor that they are consulting is not good? Is it because they are not paying for the advice, they do not feel that it is important? Or is it just the feeling that at anytime you can consult the doctor and he will take care of you despite not following any of his advice the reason for non-compliance? Whatever the reason, it is sad. So what i have started doing is not to give any undue advantage to people who i know. Collect the fees in most situations, advice them as i would to any patients and be strict that they comply . Even though this may make them feel bad at the beginning i feel that this is what is good for them in the long run.