Yesterday I came down on the Times — so today I’ll give them some credit for Jane Brody’s article on health literacy.
Seems that regardless of someone’s level of education, socio-economic status, age, race, etc, we are equally capable of being considered as “low health literate.” The article reviews two studies that cite earlier death or a lower quality of life for people who lack health literacy. One study showed that up to 90 million Americans are considered to have less than adequate understanding of what they need to know about health.
Health Literacy is defined as remembering and/or understanding less than half of what a doctor says, or having less than a basic understanding of health information.
This could result from inadequate literacy skills to begin with (unable to read, or not understanding English well enough, or whatever language the doctor speaks), to seeing a doctor who uses med-speak and doesn’t explain what those big words mean. One way they tested health literacy rates was to give the test patients instructions for taking a medicine, and then test them on their understanding of the instructions. Some of their responses were pretty scary.
Regardless of these measurements and numbers about literacy — it seems to me that communication between patient and doctor MUST BE A TWO WAY STREET. By all means, let’s come down on doctors who use their big words. But let’s come down on patients, too, who don’t ask for explanations.
It seems to me that there are two approaches to fixing this. One way is to improve the literacy aspects — improved reading abilities and/or materials that will help a non-reader or non-English speaker understand better. Charts, graphics, materials that don’t rely on words so much as pictures can help that.
But the other way is to tell many (not all) doctors, and yes, some patients too, to get over themselves! When we subtract egos from the mix, when doctors and patients collaborate and develop a mutually respectful partnership, then communication is vastly improved and all parties benefit.
That’s the perfect world. Unfortunately, the very doctors and patients who need to hear that message are the ones whose egos cover their ears.