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In marketing, "perception is everything", or at least it is a major factor in its challenge of influencing human behavior. In the early days of health care marketing in the 1970s and 80s, the federal government refused to include "marketing" expenditures as "allowable costs" in its "reimbursement" schemes. So it was necessary to re-label "market research" expenditures as something such as "community health assessment", and "marketing communications" as "community information/education". That usually took care of any problems.
"Compliance" has long been the accepted term for challenges such as getting patients to fill and refill their medications prescriptions, take them as directed, and make behavior/lifestyle changes as directed by physicians. It correctly indicates that patients are supposed to follow directions given by others, as one is supposed to "comply" with laws and military orders, to "obey".
'Adherence' means sticking with it
Since what they are supposed to do is follow a "regimen", a word from the same source as "regime" and "regimentation", suggesting "rules" and outside direction, this reflects the reality that patients are supposed to follow the directions of physicians.
In recent years, however, the word "adherence" has become popular as an alternative to "compliance". After all "compliance" denotes "knuckling under" to another's orders, "yielding", "obedience", even "subservience". Synonyms for "compliance" include "capitulation", "bowing and scraping", "boot-licking" - none the sort of thing patients could expect to be particularly proud of "Compliance" reeks of patients being "managed" by authority, which may be an accurate description of traditional medical relationships, but is not "good PR".
By contrast, "adherence" means being faithful or loyal to a cause or person, "sticking with it", even "tenacity", and indicates a voluntary adoption of behaviors, rather than a servile acceptance of orders. It is something that people could well be proud of, or at least not ashamed to admit, compared to "compliance". And since patients rarely have a legal obligation to do what physicians prescribe (taking TB medications is one exception), "adherence" is probably more accurate.
Physicians' "authority" still applies to their ability to "write orders" regarding medications, of course. They still "give orders" to nurses, therapists, and other paraprofessionals in hospitals and in their own practices. But when it comes to patients, there are increasing numbers of cases where...