In part 2 of an occasional series for Connect Savannah readers, Andrew continues the discussion of the communication gap between patients and health professionals and ways to improve health care using the “currency” of health literacy.
Part 2: How to help your patients be healthier with health literacy
When health professionals speak with patients, it’s important that they pause and consider the person they are speaking with and not just the disease or condition the person may have. Doctors, physician’s assistants, and nurses need to carefully consider the words they use, how quickly they are speaking, and the complexity of what they are saying.
They also need to make sure that what they’re saying is actually relevant, useful, and empowering to the patients they work with.
Let’s “listen in” on a conversation that should occur much more often than it does in reality:
Over-worked but caring doctor: Hello, my name is Doctor DoRight, what is your name?
Overweight middle-aged patient: I am Ms. WantToBeWell.
Doctor DoRight: How are you today, Ms.GoingToBeWell? (They both chuckle.)
Ms. WantToBeWell: Well, I am a bit worried. I seem to get dizzy a lot these days, and I just don't have any energy.
Doctor DoRight: I want to take a sample of your blood and test it. Please let me check your blood pressure and listen to your heart and lungs. OK? We will learn a few things about you, and together can develop a plan to help you feel much better.
Ms. WantToBeWell: OK. I really want to know why I'm feeling this way.
Doctor DoRight: Can you also please tell me about your eating, and how often you exercise? Also tell me about what worries you – what we sometimes call stress.
Ms. WantToBeWell: Are you sure it's necessary to know all those details? Can't you just give me some pills or something?
Doctor DoRight: I assure you it is very important information that will help us help you lead a healthier life – and we also promise to protect your personal information.
Ms. WantToBeWell: Oh! Well, okay then... I am worried all the time about my family. We never seem to make ends meet. I can't remember the last time I exercised. I just don't have time. I eat a lot of fast food to try to save time, but then I realize it costs so much and doesn't really save time.
Doctor DoRight: My job is to be your health partner, and I have a lot of tools to help. Sometimes that may be medicine, but often there are simple, small steps you can take every day that can be better than depending on a medicine. For example, your blood pressure is a bit high today. That may be part of why you are dizzy. Do you use a lot of salt when you cook?
Ms. WantToBeWell: Oh yes, I like to put salt on everything.
Doctor DoRight: How about trying to use less salt? Just put away the salt shaker for one meal, and see how that goes. I'm asking you to try that because eating salt can cause many people to have higher blood pressure than is healthy. I'd also like you to try to give yourself 5 minutes a day to just relax and try to stop worrying. Find something fun you like to do. Then maybe you can make that 5 minutes into10 minutes. Will you try that?
Ms. WantToBeWell: Sure, I can try.
Doctor DoRight: Great! We'll get the results from the tests next week. Can you come back then? We can re-check your blood pressure and talk about other things you can do to be healthier and happier. Also, next time you want fast food, I'd like you to go to the grocery store instead and buy some fresh fruit and vegetables to enjoy in a meal. You may find you spend less at the store compared to eating out. Now, can you tell me what you are going to do different until I see you next week?
Ms. WantToBeWell: First, I'm going to try to not use salt so much when I cook or when I eat out. I'm going to try to enjoy one meal without adding salt. I'm going to try to relax and have fun for at least 5 minutes every day. And I'm going to see if I can save some money by shopping for fresh food instead of having fast food.
Doctor DoRight: That is great! As we continue to get to know each other and work together, we will both keep a close eye on your blood pressure so we can get you healthier soon.
Ms. WantToBeWell: Thanks! See you next week.
Health professionals should always help patients to find, understand, evaluate, communicate, and use information to make the health literate choices that lead to healthier, happier lives. Whether you’re the health professional or the patient, do all you can to form a partnership that is based on honest conversation and consideration of all aspects of everyday life. The results can be life-changing for both of you.
Andrew Pleasant is Senior Director of Research and Health Literacy for Canyon Ranch Institute and a member of the Institute of Medicine (IOM) Roundtable on Health Literacy. He is also co-author of the book Advancing Health Literacy: A framework for understanding and action.