In the US, no matter how long they've been practicing, doctors tend to drastically overestimate their patients' likelihood of sticking to regimens. It's the medical version of the Lake Wobegon syndrome: Doctors consider their own patients to be above average. One study asked physicians to predict adherence only among patients they knew well, and the doctors still grossly overestimated.
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Doctors also overestimate their own performance, according to research. They do a good job, don't get me wrong. But they think they are doing an even better job. Most patients who are dissatisfied simply move on a new doctor without sharing feedback. And someone who ends up really sick may proceed to a specialist or hospital rather than returning to the doctor. When we have EMR systems that connect all the points of care, we'll have a better feedback loop. I hope the reporting structure will help alert doctors to patients with whom they have lost touch. Other than that, it's our responsibility as patients to speak up if we are not satisfied with the care we received.
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