Tamsin Constable

Medical literacy: not about reading

Millions of people suffer health problems because they can’t read, understand and act on medical information. The American Medical Association estimates that nearly half of all Americans have health literacy difficulties of some form.

I watched the AMA’s video on You Tube (thanks to Cheryl Stephens from the Plain Language Advocates Group on Linked-In). It’s a bit long, so I thought I’d do a summary of some of the quotes, comments and solutions.

“I was sick a lot because I didn’t take the dosage right. I didn’t understand and I didn’t have the nerve to ask them to right way.”

“I had an abscess in my ear. I had to fill out forms that I couldn’t fill out. I ended up having to go to ER.”

“You’re talking to an intelligent doctor and these people are using words you don’t even know. So you come out of that room thinking, I hope I don’t make a mistake with my medicine, because I didn’t understand.”

All of these quotes support the findings of Professor Mark V Williams’ team at Emory University School of Medicine: that people with literacy problems are more likely to be hospitalised for chronic illness, at enormous cost to the economy ($50-$73 in the US), on top of unnecessary suffering.

There are legal consequences too. Someone who signs a consent form without understanding it has not, in fact, given informed consent to anything, signature or not. They can sue.

The answer here, as in many fields, is take the word ‘literate’ to mean ‘understand’ rather than ‘able to read and write’. Once professionals – health or otherwise – take that on board, they can think of simple, creative, elegant and effective ways to make sure that their patients (clients, customers, service-users etc) have got the message.

Like taping individual sample pills to a cardboard chart. Or explaining concepts using vivid ‘living room’ language and metaphors. Or remembering not to ask “Do you understand?” but to find other ways of checking understanding.

As one doctor, Cheryl E Woodson, said, “It almost doesn’t matter why they’re having problems understanding: it’s my job to overcome that barrier so I can get them the information they need to let me help them.”

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