Communicating health information to your patients is something you do all day every day. Can you be sure that the medical language you use with your patients is clearly understood? Are patients able to read and comprehend the printed materials and forms you may provide them?
How do you know?
Poor health literacy has been identified as a growing public health issue. It crosses all ages, nationalities, and socioeconomic levels. Surprisingly, a patient's degree of education is not a reliable indicator of his or her ability to understand the health information that you provide. Low health literacy has a costly impact on our health care system. "Individuals with limited health literacy incur medical expenses that are up to four times greater than patients with adequate literacy skills, costing the health care system billions of dollars every year in unnecessary doctor visits and hospital stays." (1)
Patients who do not adequately understand their diagnosis and treatment may even contribute to medical errors by failing to communicate important information to their health care professional. "Low literacy plays an important role in health disparities and may contribute to lower quality care and even medical errors," said Dr. Carolyn M. Clancy, director of the Agency for Healthcare Research and Quality. (2)
Patients may be unsure of the kinds of questions to ask their physicians during appointments or when they are scheduled for a medical test or procedure. Their physician may be explaining multiple health conditions and treatments that are difficult to grasp, or their diagnosis may cause fear or shock. They may feel intimidated by the medical language used and embarrassed that they are having difficulty understanding. When patients pick up prescription medications, they may not know the questions they should be asking their pharmacist. Statistics from the Center for Health Care Strategies, Inc. indicate that only half of all patients follow directions when taking medications.
To address these issues, the Partnership for Clear Health Communication at the National Patient Safety Foundation has developed an educational program called Ask Me 3 "to promote clear communication between patients and providers." (3)
Experts from this coalition developed three questions that patients should always ask their health care professional and that health care professionals should assist their patients in understanding. The three questions are:
- What is my main problem?
- What do I need to do?
- Why is it important for me to do this? (3)
The Ask Me 3 web site provides patients with information on how to communicate with their medical professional and promotes the idea of "good questions for your good health." It outlines for the patient the best time to ask questions and what to do if he or she still does not understand.
One section of this web site that may be particularly enlightening for health care professionals is the "Words to Watch Fact Sheet." Here, common problem medical words, concept words, category words, and value judgment words are identified, and a list of alternative, more familiar words for patients is substituted. An awareness that some Latin or Greek words may be confusing to patients or that common words may take on a different meaning is helpful when communicating with patients. (4)
A sampling from this section includes:
| Problem Word | Consider Using |
|---|
| Medical word: |
Benign |
Will not cause harm; is not cancer |
|
Dysfunction |
Problem |
| Concept word: |
Avoid |
Stay away from; do not use (or eat) |
|
Gauge |
Measure; test; get a better idea of |
| Category word: |
Adverse (reaction) |
Bad |
|
Cognitive |
Learning; thinking |
| Value judgment word: |
Cautiously |
With care; slowly |
|
Excessive |
Too much |
In addition, to facilitate greater understanding, health care professionals are encouraged to use examples or visual aids with patients when explaining health conditions and treatment plans. Former Surgeon General Richard H. Carmona, said "health literacy is the currency of success for everything that we do in primary and preventive medicine. Health literacy can save lives, save money, and improve the health and well-being of millions of Americans. All of us — government, academia, health care professionals, corporations, communities, and consumers — working together can bridge the gap between what health professionals know and what patients understand, and thereby improve the health of all Americans." (2)
More information on Ask Me 3 is available in a recent article from American Medical News.
Sources
- American Medical Association Foundation. Health Literacy. September 4, 2007. Available at http://www.ama-assn.org/ama/pub/category/8115.html. Accessed May 2, 2008.
- Agency for Healthcare Quality Research. New evidence report illustrates links between health literacy and health care use and outcomes. Press release April 8, 2004. Available at http://www.ahrq.gov/news/press/pr2004/litpr.htm. Accessed April 30, 2008.
- Ask Me 3. What is Ask Me 3? Available at http://www.npsf.org/askme3/PCHC/what_is_ask.php. Accessed April 2, 2008.
- Ask Me 3. Words to watch — Fact sheet. Available at http://www.npsf.org/askme3/PCHC/download.php. Accessed May 2, 2008.
Dana Leidig can be reached at dana-leidig@tmlt.org.
