Abstract

Care for patients is generally delivered under the context of an unwritten contract with few clauses, among them being that the physician will educate the patient about treatment options and recommend the treatment that they believe will be most likely to help the patient and that the patient will do their best to follow the agreed upon treatment plan. As the treatments for inflammatory bowel disease have become more complex, the demands placed on patients to complete pretreatment screening, monitoring, and health maintenance activities have also increased. Physicians caring for these patients face challenging decisions when patients do not adhere to the recommended protocol. This commentary discusses potential implications of different approaches to this clinical dilemma.

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