Holding Patients Accountable™…

new car oil change
new car oil change

When you purchase a new car, you are told to have the oil changed every 3500 miles to keep the engine running smoothly. You are even given some incentives (antecedents) such as “First Oil Change Free,” or “Lifetime Oil Changes!”  However, it is still your responsibility to schedule, bring your car in, and have your car serviced.

How absurd would it be to penalize the dealership for your failure to get your oil change?

If we were to perform a consequence analysis on an oil change from the car owner’s perspective, we find some very interesting stuff…

First, there are four different behaviors:

No Oil Change Ever Buys Oil, but does not change Oil Gets First Oil Change, but no future Oil Changes Gets Regular Oil Changes as directed
There are many antecedents
that sets the stage
for or against
an oil change:
Behavior Alternatives: Consequences:
  • incentives
  • warranties
  • extended life of car
  • warning lights
  • owners manual
  • oil sticker
  • burning oil smell
  • engine knocking
  • cost of oil change
  • future cost of engine repairs
  • time
  • Regular Oil Changes
  • —————
  • Sporadic or No Oil Changes
  • Longer car life (PFCA)
  • Dependable Vehicle (PICA)
  • Increased Oil Cost (NICA)
  • Time to get Oil Change (NICA)
  • —————
  • Lose Vehicle (NFUA)
  • Time for engine repairs (NFUA)
  • Cost for new engine (NFUA)
  • No cost for Oil (when no oil change)(PICA)
  • No time (when no oil change)(PICA)

As shown in the table, there are several positive, immediate, certain, and aware of the consequences for NOT changing your oil on a regular basis and several negative, immediate, certain, and aware of consequences for changing your oil regularly. In the immediate, there is no cost of time or money by NOT getting the oil change. The possible negative consequences are all in the future and they are not certain to happen.

However, getting a regular oil change has negative, immediate, certain, and aware of consequences, including time and money, but the benefits are all in the future. What would prompt an owner to get regular oil changes?

From a responsibility and accountability standpoint, if the owner wants to maintain the car in good working condition for a long period of time, then regular oil changes are a necessity. It is the owners responsibility to perform the behavior. Should we penalize the mechanics, the dealerships, the manufacturers, or other car owners for the behavioral choice of this owner to NOT get an oil change? Absolutely not!

But, this is exactly what is happening in health services. The person most responsible for the outcome of their own health, is not held accountable for the behaviors necessary to achieve those outcomes. Furthermore, the providers, hospitals, and fellow tax payers are all penalized (using withholds or higher premiums), for the behavioral choices of patients who do not follow their plan of care.


BEARS AdM Coaches identify “At-Risk” non-adherent patients, help those patients identify the negative consequence in a plan of care and then, develops an Adherence Improvement Plan to positively reinforce the right choices that produce improved outcomes. Let us help you, help your patients make the right choice!

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