Cost or compliance?

August is here.

It is early yet but so far one third of my deliveries this month have syphilis. Syphilis is cheap to diagnose and treat. All these are new cases. The state mandates testing at least three times in pregnancy and I have been able to get records on patient showing negative test results with in the past year.

It is, however, a difficult job to make sure these women are adequately treated since follow is required and most of them do not return unless they are sick or get pregnant again. It is even more difficult to get their sexual partners treated. That is where the health department comes in. Babies have to stay for 10 days of intravenous antibiotics.

The greatest obstacle in any health care system is patient compliance. If the patient will not take the medicine, follow the treatment plan, return for re-evaluation, even the best attempts at treatment are futile.

So, while the rest of the country is debating the cost of health care, those of us providing health care know compliance is key. We also know compliance is not always tied to cost.