Health literacy: Too important for the back burner

When a healthcare marketing agency is working on a direct to consumer marketing campaign, one of its chief concerns is making sure the ads speak to members of the public in a language they understand. All too often, physicians don't take this step or overestimate their patients' health literacy, which can have disastrous results. Important information may get lost in translation without doctors realizing, and their patients will ultimately leave with more questions than answers.

"Just 12% of adults are proficient in health literacy."

In an article he penned for City Limits, Dr. Matthew Weissman, chief medical officer of New York-based nonprofit Community Healthcare Network, noted that inadequate health literacy can result in hospitalization, avoidable emergency room visits, confusion about prescription drugs and even the worst-case scenario of death. Insufficient health literacy costs the country as much as $236 billion per year, Weissman stated. At first, this number may seem unbelievable, but it becomes considerably more plausible when you consider these statistics:

  • Just 12% of adults are proficient in health literacy, according to findings from the National Assessment of Adult Literacy.
  • More than eight in 10 (82.1%) of adults in the United States had contact with a healthcare professional in 2012, the most recent year for which statistics were available, according to the Centers for Disease Control and Prevention's Summary Health Statistics for U.S. Adults: National Health Interview Survey, 2012. For children, this figure was even higher at 92.8%.

"Too many individuals cannot read their prescription instructions; they do not understand their hospital discharge papers, they cannot decipher their treatment plans and they misinterpret their diagnoses and prognoses," Weissman stated. "The results can be damaging, costly and even deadly. Only when healthcare professionals begin to clearly communicate with patients will we be able to mitigate health literacy problems and ensure better healthcare outcomes."

"Patients bear some responsibility for their own medical care."

Asking the right questions
Although doing everything possible to help patients is part of a physician's job, patients also bear some responsibility for their own medical care, Weissman asserted. With this in mind, he listed three questions that patients should be sure to ask at every doctor's appointment:

  • "What is my main problem?"
  • "What do I need to do to address this problem?"
  • "Why do I need to take this action?"

If prescribed medication, patients should make sure they understand the basics: what the medication is for, how much to take, how often to medicate themselves, what side effects may occur and what to do if they experience these, etc. Similarly, if they need to undergo tests, they should know what each test is for, when and where it will be conducted if the doctor can't perform it there and then, how it will be carried out, any side effects they can expect and how long they will have to wait before getting the results.

In a blog post for the Daily Trojan, a University of Southern California publication, USC student Francesca Mares-Do noted that research has revealed many patients don't understand the conditions from which they suffer. Mares-Do asserted that lack of proactivity on their part often contributes to their confusion.

"Ask the questions that need to be asked or clarify again just to make sure you understand," advised Mares-Do. "You might feel embarrassed for not understanding what the doctor said the first time, but you'll feel twice as foolish for leaving without ever knowing what he meant."

Patients shouldn't leave the doctor's office with more questions than answers.Patients shouldn't leave the doctor's office with more questions than they walked in with.

Providing information in the right format
In order to provide quality healthcare services to patients throughout New York City, the Community Healthcare Network adheres to a three-pronged patient health literacy approach that Weissman believes all of the country's medical offices would benefit from adopting. To bolster health literacy and reduce instances of avoidable trips to the ER, hospitalization and death, the information doctors impart to their patients should be:

  • Simple: Physicians should save the medical jargon for conversations with healthcare professionals and speak to their patients in plain English simplified to a fifth-grade level. In the case of individuals whose native tongue isn't English, doctors should communicate in the patient's first language or find someone who can.
  • Offered in more than one format: As well as delivering information orally, physicians should provide patients with easy-to-read written materials. Encouraging patients to take notes is also a good idea, as the memory of an oral conversation can quickly fade.
  • Repeatable: Doctors should employ the "teach-back" method to gauge their patients' level of understanding. Encouraging patients to explain the information they were given in their own words provides an opportunity for physicians to correct misunderstandings and supplement knowledge.