Global Health Systems 1st Edition by Margie Lovett Scott ,Faith Prather

Exercise 12

Case Scenario
Mr. Vladismar: Why Not CAM?
Mr. Vladismar is a 78-year-old who lives in a small rural community in the Russian Federation. He enjoyed reasonably good health for many years, which he attributed to hard work and healthy eating habits. He has been followed for four years by a doctor in a nearby private clinic for chronic breathing problems. He has been seen in the clinic by the same doctor five times in the past two month for worsening of his breathing problems and each time he has had his medications adjusted or changed. He is considered by his physician to be non-compliant, demanding and difficult to treat. During his last visit he became increasingly anxious and depressed about his chronic breathing problems and lack of energy. His doctor wants to draw blood to send for lab analysis but Mr. Vladismar refuses, saying it is too costly. He repeatedly questions the doctor about why he is not improving as he has been on so many different medicines and done everything he was told to do? After his last visit to the clinic, he told his wife he would not go back. Soon after, Mr. Vladismar began seeing a doctor who specializes in CAM; although not yet improved he believes he will get better if he continues to see the CAM specialist.
What explanation can you provide for Mr. Vladismar's refusal to pay the fee to have labs drawn and to his refusal to return to the clinic, especially as, according to the price list, these costs are relatively low?