Culturally competent professionals in therapeutic alliances enhance patient compliance

Medical training has traditionally focused on diagnosis and treatment of di sease, with the notion that these two factors are satisfactorily managed, t he desired outcome will inevitably follow. When it does not,failure is ofte n blamed on patient noncompliance. Failure of patients to return for follow -up visits or comply with medication regimens has been shown to be a major barrier to the delivery of effective medical care. However, effective clini cal decision making requires that physicians skillfully address not only th e biomedical aspects of diseases and their management, but also the sociobe havorial characteristics of patients. The authors maintain that patient par ticipation is necessary for compliance and that a naturally occurring thera peutic alliance between physician and patient incorporates factors such as lifestyle,family, and living circumstances and an awareness of the cultural ly unique needs of minority patients. Integration of these factors into pro fessional decision making and practical management plans will enhance patie nt compliance.