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Most clinicians can sense when it’s coming. Appointments start getting spaced out. Exercises aren’t quite being done. Progress stalls. Patient dropout isn’t usually sudden — it’s gradual, predictable, and often misunderstood.
That’s why this week we’re diving into why patients disengage from rehab, and what actually helps them stay committed long enough to see results.
We’ve all seen it—some patients fully commit to their rehab, while others disappear after a session or two. Why does this happen?
On average, non-adherence can reach 50%—which means half of our patients might not be following through(1), however, there is research suggesting this number could actually be higher(2) in some populations.
So, what’s stopping them?
👉 Common barriers include low confidence, anxiety, depression, lack of support, and pain during exercise(3).
👉 But it’s not just physical or mental hurdles—what we say and how we say it matters.
A fascinating paper by
Courtney, Spivey, & Daniel 2014 highlights how
behavioural economics (BE) can help patients make better decisions. Turns out, people don’t always act logically—they’re influenced by emotions, how information is framed, social pressure, and whether the easiest option is the best one.
Big takeaway: It’s not just what we tell patients—it’s how we tell them. If we recognize the hidden forces shaping their decisions, we can make sticking to rehab easier, not harder.
💡 Two Potent Questions to Improve Patient Buy-In
1️⃣ Am I making the best choice the easiest choice?
Patients often default to the simplest option—which might not be the best one.
Are we removing barriers to adherence, or are we expecting them to fight against inertia?
2️⃣ Am I focusing on what the patient finds relevant, or what I think is important?
We know what the research says, but patients pay attention to what feels urgent to them.
Can we reframe our advice to align with their personal goals and immediate concerns?
🔍 Are We Talking in a Way That Patients Actually Hear?
It’s easy to assume that giving patients more information will lead to better decisions, but BE suggests the opposite—people act on what feels urgent, not just what’s true.
❓ How do you adjust your messaging so that patients are more likely to absorb it?
📊 Infographic: “11 Ways Your Patients Are Secretly Making Decisions” You know patients don’t always make decisions logically—but do you know
what’s really driving their choices? This quick-reference guide breaks down the 11 key biases from behavioural economics and shows how they impact clinical care.
Read more in this blog! Download the infographic here! 
"People don’t choose between things. They choose between descriptions of things." — Daniel Kahneman, Thinking, Fast and Slow
Patients don’t make decisions based purely on logic—they are influenced by how information is framed, what feels relevant, and what others are doing. This aligns perfectly with the research on behavioural economics in clinical practice, showing that how we present treatment plans matters just as much as the plans themselves.
👉 If we want better patient adherence, we need to rethink how we communicate.
Stay nerdy,
