Lack of health literacy can be fatal

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Pauline Chen, M.D., wrote in The New York Times about “health literacy,” arguing that both patients and doctors share the responsibility of ensuring that patients truly understand their conditions and the behavior expected to them.

Chen tells the story of one patient, a former professional athlete suffering from diabetes and other chronic ailments, who died after he was discharged from the hospital because he did not take proper care of himself.

Dr. Rebecca L. Sudore, assistant professor of medicine at the University of California, San Francisco, was lead author on a “landmark study that linked limited health literacy to higher mortality rates.”

Dr. Sudore went on to suggest ways in which doctors and patients might address health literacy. “One thing we tell clinicians to do is to ’teach back’ or ’teach to goal.’ A clinician might say, ’I’ve just said a lot of things and I want to make sure I’ve explained things clearly to you. Can you explain things back to me, so I know you understand?’ This discussion creates a kind of a shared understanding. The doctor may not have the time, but these questions can bring up red flags that can be discussed during a follow-up appointment.”

For patients, Dr. Sudore recommended taking the initiative to tell the doctor how much is understood. “You should go back to the doctor and say, ’What I hear you saying is this. Did I get that right?’ Or, ’I’m leaving the hospital. You just gave me this new drug, but I’m still supposed to take all my other medications. Is that right?’ ”

Hear more about the topic at Health Journalism 2009 at the panel “Health literacy: Does the public understand you?

Andrew Van Dam

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