Sunday, April 12, 2015

Medical Illness and Treatment Literacy

Medical illness is a part of life. No matter what your age, your ethnicity or where you live, you will, at one time or another, experience an illness and you will need medical treatment. Successful treatment of any disorder, be it psychological or medical, contains two central components; the medical expertise employed and the patient literacy. The literacy portion does mean that patient education and compliance must be addressed for the optimal result wished.

How well does the average patient understand what they're being told by a healthcare professional? Not very well at all according to a study by the Centers for Disease Control which produced a pamphlet in 2009 addressing this very issue of literacy as it related to older adults.  The question of what is presented and how it is presented for most effect is paramount. After all, the best medical treatments cannot do the best job for the patient if there's a lack of meaningful communication.

Patients, of all stripes and ages, sit compliantly listening to their healthcare professionals and, often, not fully understanding what is being said. The professional fails to appreciate the fact because they're so accustomed to the medical jargon that they assume the patient will surely know. without question, what is being conveyed to them.

Often, the patients don't understand and they may feel either embarrassed, and this prevents them from asking, or they're feeling rushed so the next patient can come in.  Bookings in professional offices may be scheduled too tightly and there's little time for meaningful discussion. I know of one physician who triple books. Of course, this is unethical, but he does it just the same.

What approach might work best for this particular population of patients? First, let's consider what the National Assessment of Adult Literacy found were problem areas:

  • 71% of adults older than age 60 had difficulty in using print materials
  • 80% had difficulty using documents such as forms or charts
  • 68% had difficulty with interpreting numbers and doing calculations

Materials that fail to address these seminal issues are not receiving passing grades when it comes to helping provide optimal care for the group. The 2010 health agenda stated that:

Limited health literacy has been linked to increased health disparities, poor health outcomes, increased use of health care services, and several health care safety issues, including medical and medication errors. Improving health literacy for all Americans has been identified as one of the 20 necessary actions to improve health care quality on a national scale.

Although there may currently be greater access to healthcare and professional services, this does not insure greater utilization in terms of outcomes. This is where educational efforts must be most robust. How do we do it?

We can't ignore this imperative because by 2020 there will be 71.5 million Americans age 65 and older and they will, almost without question, need a complete array of complicated services for chronic diseases. Consider the fact that a 2003 survey found that this group has the highest proportion of individuals with "below basic" healthcare literacy. 

Is it any wonder when you consider how sophisticated medical/professional care has become since they were born? No doubt it is much more demanding cognitively and there is a crying need for communicating in terms that are meaningful to them. Not only that, but we must remember that not all of them are computer literate or possess our wonderful technology. 

I recently attended a meeting where seniors had to register their cars. It was explained that they could access this information online at the town's website. A woman turned to me and said, "But I don't have a computer." What's the solution for her?

The current objectives, therefore, must be to re-educate healthcare professionals in all fields and to establish a means of offering clear, easily understood guidelines for patients to follow. Jargon has to be avoided at all costs. If the patient can't fully understand what they're being told, it might as well not be told to them at all. It's just that simple. Compliance and complete understanding must be the watchwords.

Are your medical professionals following these new golden rules? Find out for yourself.

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