The LACRC is grateful to have Joy Fruth, MSW, guest blogging for us about how you can improve your health literacy and gain the most value from each doctor’s visit. She is a social worker and the Program Director at S+AGE™, an outpatient clinic providing comprehensive geriatric evaluation services for 24 years.
Do You Really Understand What Your Doctor is Saying?
How often has this happened to you: you finally get to see your doctor, only to spend 15 minutes in the exam room to hear a stream of medical terms that you don’t understand. Before you realize it, he’s out the door before answering all your questions.
On average, physicians spend only 13.3 minutes with patients during each exam. There’s a good chance, then, that if you are relying solely on your doctor to teach you what you need to know to manage your health, you may be cutting yourself short!
As the director of an outpatient geriatric clinic, I hear all too commonly from our patients that they don’t understand certain things about managing their own healthcare. Some are taking medications that were prescribed by another physician or in the hospital, but they don’t know the purpose of the medication or why it was prescribed for them. Others intermittently take medications that were prescribed to be taken routinely without understanding the consequences of their choice. All too often, simple errors and misunderstandings land patients in the hospital where further complications can occur — infections, falls, and increased confusion to name but a few. Many of these problems could be avoided with improved health literacy.
Health literacy is defined in Healthy People 2010 as: “the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions.” Being health literate goes beyond reading comprehension. It involves the ability to understand information that is printed on medical brochures, instructions that are found on prescription bottles, legal language found on medical consent forms, and doctor-written instructions. To be health literate involves listening, reading, communicating clearly, analyzing information, making informed decisions, and integrating all these skills to best navigate complex health care systems.
Sounds challenging? You’re not alone! Recent studies revealed that almost 50% of all Americans have difficulty understanding and acting on information that is important to their overall health.¹ In regard to elderly patients, another study revealed that those with limited health literacy are almost twice as likely to die.² With such dire consequences, we can’t afford to be health illiterate.
How can one improve health literacy? Most experts suggest that health literacy is the responsibility of the patient and the physician. “Patients shouldn’t be afraid to ask us about what they don’t understand,” says Dr. Dan Osterweil, geriatrician and founding medical director of S+AGE™, a clinic specializing in geriatrics in Sherman Oaks, California. “At our clinic, we have a conversation with patients and caregivers, where we provide them a notebook with some basic resources to help them improve health literacy and we assign them the task of writing down all the questions they have between visits. This way, they hear from the physician that I want them to ask me questions. We want to empower patients and caregivers.” Adds Dr. Osterweil, Clinical Professor at the UCLA David Geffen School of Medicine’s geriatrics division, “In our curriculum, we teach physicians how to use active listening to engage patients. Physicians are taught to ask patients to repeat back what they’ve understood from our interactions. That way we stop assuming what the patient knows and instead, hear it directly. This approach creates teaching moments, which is a benefit to physician and patient alike.”
Whether or not you and your doctor share the same primary language, it can be difficult to understand what your physician is talking about. Nevertheless, a lack of understanding can have negative and avoidable consequences. Each individual has the ability to become more health literate and resources are widely available to help. Your good health – and the health of your loved ones – may depend on it.
Want to learn more? Here are some additional resources:
Health Literacy. American Medical Association Foundation
515 North State Street
Chicago, Illinois 60610
Ask Me 3
Sponsored by the Partnership for Clear Health Communication at the National Patient Safety Foundation. “The National Patient Safety Foundation’s mission is to improve the safety of the health care system, of which health literacy is a critical component. Understanding that communication breakdowns are the leading source of medical errors, NPSF will be integrating PCHC’s flagship health literacy program, Ask Me 3, into its program offerings. Ask Me 3 promotes three simple but essential questions that patients should ask their providers in every health care interaction:
1) What is my main problem?
2) What do I need to do?
3) Why is it important for me to do this?”
References:
¹Health Literacy: A Prescription to End Confusion. Edited by Lynn Nielsen-Bohlman, Allison M. Panzer, and David A. Kindig. 345 pp. Washington, D.C., National Academies Press, 2004.
²Sudore et. al. “Limited Literacy and Mortality in the Elderly: the Health, Aging, and Body Composition Study, JGEN INTERN MED 2006, pp806-812.
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