💡 Key Takeaways

– Even doctors forget to take their medication. – Poor medication adherence can lead to serious emergencies. – It’s okay not to be perfect — just don’t give up.

My Father’s “Just Because”

I wanted to kick off this blog with something dramatic — chest pain, aortic dissection, the kind of cases that define emergency medicine. But a recent personal experience felt more real, more relatable, and honestly more worth writing about. So for my first post, I’m starting with medication adherence. Here’s what happened. My father cut his finger and came to the ER for sutures. After the procedure, he was prescribed antibiotics and anti-inflammatory pain relievers. And then he turned to me — his son, a doctor — and asked if he really had to take them. I told him yes, absolutely — infection prevention is not optional. But he just kept saying he didn’t feel like taking them. When I asked why, his answer was simply: “Just because.” Because he’s my father, I took a deep breath and calmly said, “You need to take these so your wound heals properly. Please take them, even if you don’t want to.” That’s how I finally got him to take his medication. If a patient had said the same thing to me in a clinical setting, I’d probably try to persuade them once or twice — but if nothing worked, I’d likely end up saying “It’s your choice” and walking away.

Even I Forget My Medication

Here’s a confession: I also have medications I’m supposed to take every day — and keeping up with them consistently is harder than it sounds. As an emergency physician working rotating shifts, my days and nights are constantly flipped. Chronic sleep deprivation takes a real toll on short-term memory, and details just slip away. There have been times I couldn’t remember whether I’d taken my morning or evening dose, and I’d end up fishing the empty pill packet out of the trash to check. Once, I took an extra vitamin because I genuinely couldn’t remember if I’d already had one. If even a doctor struggles with this, imagine what it’s like for patients.

Medication Adherence in the Real ER

The ER sees all kinds of patients — but a significant number come in because of poor medication adherence: skipped doses, missed follow-up appointments, or neglected lifestyle changes. Patients with chronic conditions like hypertension or diabetes need consistent medication management. But I regularly see patients who stopped their medications because they thought “long-term use must be harmful,” or assumed “my numbers looked fine, so I figured I could stop,” or simply missed one clinic visit and never went back. Many of them arrive with systolic blood pressure over 200 mmHg or blood glucose over 500 mg/dL. Unmanaged hypertension can lead to life-threatening emergencies like intracerebral hemorrhage or aortic dissection. Poorly controlled diabetes can result in diabetic ketoacidosis, silent myocardial infarction, or acute kidney injury — conditions that bring people straight to the ER. With traumatic injuries like lacerations or burns, the skin’s protective barrier is compromised. Patients who skip antibiotics, neglect wound dressing changes, or miss follow-up visits can develop infections that escalate from outpatient management to full hospitalization.

Why Don’t Patients Take Their Medication?

So why do patients stop taking their medication and avoid coming back to the clinic? Based on what I’ve heard directly in the ER, it comes down to three main reasons.

1. “I feel fine, so I must be fine.” When there are no symptoms, it’s easy to feel like there’s no disease. This is exactly why hypertension is called the “silent killer.” The damage is happening — you just can’t feel it. One of the most common things I hear in the ER is “My blood pressure has been fine lately.” Often, that same patient’s blood pressure is over 200 mmHg.

2. “Taking medication long-term must be bad for you.” This is one of the most persistent misconceptions. Yes, every medication has potential side effects. But in most cases, the consequences of abruptly stopping blood pressure or diabetes medication are far more dangerous than any side effect. Intracerebral hemorrhage. Aortic dissection. Diabetic ketoacidosis. These are among the most critical emergencies we manage in the ER.

3. Life just gets in the way. Honestly? This is the most relatable reason of all — for my father, for me, for everyone. Taking pills is inconvenient. Booking a clinic appointment feels like a hassle. Miss one visit, and it’s easy to just stop altogether. It’s hard to call this laziness. It’s just being human.

Please Don’t Give Up.

With all of that said, here’s what I really want you to hear. I completely understand not wanting to take your medication. I understand dreading another clinic visit. I struggle with the same things. But working in the ER, I’ve seen too many people put it off — and end up in a far worse situation because of it. The patient who had a stroke and lost movement on one side. The patient who went to the ICU with DKA. The patient whose finger infection spread to their entire hand and required hospitalization. Every one of them started with one small thing left undone. You don’t have to be perfect. Just don’t give up. I’m going to take my medication today, too. 😊

📚 References
– Vrijens B, et al. “A new taxonomy for describing and defining adherence to medications.” Br J Clin Pharmacol. 2012.
– WHO. “Adherence to Long-term Therapies: Evidence for Action.” 2003.
– American Heart Association. “2023 ACC/AHA Guideline for the Diagnosis and Treatment of Hypertension in Adults.” 2023.

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