Published on 12 February 2026

Last week, I spent time with final-year medical students in rural district hospitals in the Eastern Cape.

As part of their workplace-based assessment, I observe while they consult with patients.

On this occasion, we saw a middle-aged man in the outpatient department. He had stopped taking his HIV medication and now wanted to restart treatment. As the student began the consultation, the door opened and a nursing sister announced, “Doctor, the patient is also a hypertensive defaulter.”

When I hear the word defaulter, I feel uneasy — a tightness in my chest. The word default implies that the patient is “at fault.” It becomes a label the person now carries. Yet we don’t know what happened that led to the interruption.

This patient explained that he developed severe headaches whenever he took his antihypertensive medication. The experience was so unpleasant that he stopped the treatment.

I prefer a more neutral phrase: the patient interrupted his treatment. It allows us to notice what happened without judgement and to remain curious about the reasons behind it.

Are there any labels you’ve encountered, like “defaulter” that slip into the realm of judgment when used without context?