Health Literacy (Again)

More on Health Literacy

Health literacy is defined by the U.S. Department of Health and Human Services as “The degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions". Health literacy has become a medical term used by medical professionals to study, measure and learn communication skills with their patients (and their family).


I don’t consider myself a medical person but I do consider myself a patient safety advocate. And, since communication is one of the biggest problems with patient’s safety I will be addressing my own “Top Ten” list of how to improve health literacy.

#10. Stop using abbreviations –always. Don’t do it with friend, family or at work. Get out of the habit now. Don’t say the U.S. of A. Say “The United States of America”. Don’t say my GYN, say “My gynecologist”. Don’t say we are barbecuing dogs; say “we are barbecuing hot dogs”.

I was recently with a group of 9-12 graders and heard someone use the term LGBT. I stopped the speaker and asked if everyone in the group knew what that meant. One girl didn’t. We would assume a teenager knows that term but if it isn’t used by her friends or family, how could she know it? We need to speak in full sentences always so when speaking about healthcare, there are no surprises.

#9. Assume a patient can’t read. Healthcare workers handing patients forms to sign can ask “Do you need help with the forms?” This gives the patient the opportunity to say that they forgot their glasses, are too nervous to read the forms or anything else they want to say besides saying they won’t understand them. Friends or family accompanying the patient can ask too. Every time I go to the doctor I am handed forms to read and sign. I wonder what the person would say in a crowded waiting room if they can’t read.

#8. Have a private place to complete forms. Don’t make the patient feel embarrassed or self-conscious. Never react to an answer. If you learn the patient’s age or weight, go on to the next question and never bring it up again.

#7. The patient needs to repeat what the doctor said in their own words. And, the doctor needs to ask. “Take the pill 2 times a day for a week and then come back” The patient needs to now explain when they will take the pill. “I will take them at night” repeats the patient. “How many”? “I will take 2 at night with dinner so I remember” If the doctor wants one pill in the morning and one at night, is it at 7:00 AM and 7:00 PM? Make it easy. This isn’t about literacy it’s about explaining yourself so anyone can understand it.

I worked in the post office for 19 years and mailed packages all over the world. Recently I tried to figure out if it would benefit me to use the newer “flat rate” box to mail a package to my son in college or should I get boxes and mail them without the flat rate price. The clerk spent enough time with me until I understood. Is that about literacy too?

#6. Ask the doctor to come back. After an overload of information, whether in the hospital or the office, ask the doctor to give you a few minutes to think of the questions you may have. Write them down and gather your thoughts. The doctor or medical provider should suggest, “I know that was a lot of information, why don’t I see another patient and check back with you to make sure you still understand what I said”.

#5. If you don’t understand your doctor, and he has explained the same thing over and over, ask the nurse to explain it. You can tell me how to do something and what to do but if I didn’t get it the first three times you said it, you better either pick new words or get someone in who speaks in a way I understand it.

#4. People with accents aren’t deaf. People who are deaf, are not dumb. People who are elderly are not all frail, people who are young have a right to ask questions. People in wheelchairs can hear. Don’t talk to their transportation person and ignore the patient. If the patient has a disability, they probably know it. Don’t be afraid to acknowledge it and ask how you can help.

#3. If your doctor doesn’t spend the time explaining him/herself on more than one occasion, don’t be afraid to change doctors. Just because you have used this doctor for 20 years doesn’t make that doctor “good”. There are always new and competent doctors being trained. Look for a new one.

#2. Remember “making meatloaf”. You can share your meatloaf recipe with 10 people and no 2 will come out the same. If every detail isn’t shared, you may not get the outcome the doctor expects. Details, details, details!

#1. NEVER let a medical professional intimidate you! I was recently with a patient in the hospital and the doctor stood over her bed and said to the patient “What are you so worried about?” The patient, an educated woman, sick of being in the hospital started crying. I jumped in front of the doctor and said “Just answer the woman’s question”. Healthcare providers will get much further answering the patient’s questions and if not able to, tell them.  Be honest and forthright with the patient about your own limitations in communication.

If we don’t follow the care plan we are considered “noncompliant” if we don’t understand the care plan, we have low health literacy.

How about we just get everyone communicating a bit better?