The Health Illiterate Patient Wrongly Judged

Today I witnessed a clinician make assumptions about a patient (and wrongly judge the patient) based on the patient’s appearance which consisted of handsome looks, classy clothes, clean grooming, and nice presentation. What the clinician didn’t know is that underneath the nice appearance actually sat a patient who had comprehension problems and communication limitations; a patient who was “health illiterate.” (Yes, for non healthcare folks reading – that is a real term).

The caregiver was made to sit in the waiting room while the patient was taken in to see the clinician for testing. The clinician prevented the caregiver from going with the patient saying that:

• The caregiver wasn’t permitted
• There were HIPPA issues (although the patient had given consent in writing that the caregiver was his caregiver)
• The patient “looks like a man who can do just fine on his own… unless of course he needs an interpreter”

In today’s day and age, families often assign caregivers when a family member is sick. Sometimes there are multiple caregivers. Caregivers help the patient to retain information, help guide the patient in their treatment, and relay info to others. In many cases caregivers are needed due to health literacy problems. I know as I have been a caregiver in the past for these reasons. I am also a caregiver now, and I work in healthcare communications and understand the importance of health literacy and the limitations and potential outcomes that can occur when a patient is health illiterate. Sadly, it looks like those on the front lines of care are forgetting about health literacy in their communications to patients (at least in what I experienced today).

Health literacy remains a very big problem in the United States. Some documented facts:

• 46 million American adults are functionally illiterate.
• 40 million Americans read at or below 4^th grade reading level.
• Nearly half of all American adults –90 million people– have difficulty understanding and using health information.
• The average American comprehends between a 4th – 7th grade level.
• 26% of Americans can’t understand when their next doc appt is scheduled.
• 42% of Americans do not comprehend instructions to “take medication on an empty stomach.”
• 49% of Americans cannot determine if they are eligible for free care by reading hospital financial aid forms.
• 60% of Americans cannot understand a standard consent form.

Even well educated people with strong reading and writing skills may have trouble comprehending a medical form or doctor’s instructions regarding a drug or procedure. At some point, most individuals will encounter health information they cannot understand. This is why caregivers are so important.

Shame shame on this clinician today! Health literacy can strike even the well groomed. And clinical staff needs to think better than make assumptions. By making assumptions the patient can walk out confused and it can just cause the family a lot stress; making caring for the patient more difficult as one doesn’t know what has been communicated.

As the old saying goes “a book should never be judged by its cover.”  What I witnessed today I never want to witness again.

Are the medical and nursing schools teaching health literacy to students these days? I really hope they would be. Its great the medical societies like AMA, AAFP and ACP take on this role, but where do the medical schools stand with this? Id really like to know.

As a healthcare communicator, I never lose sight of health literacy in my work. Personally, I’m thankful it plays such a big role in my life as I am able to help myself, my family, and my friends muddle through potential challenges it may create.