Do we really understand each other?
By Paula Erwin-Toth
A hot topic in health care journals is “Health Care Literacy.” When we hear the word literacy, we often think of being able to do the three R’s: reading, writing and arithmetic. But in health care lliteracy means something else entirely: are people able to read, visualize, and comprehend medical terms, descriptions, and directions related to their health care? US health care providers have often been remiss in this area. Terminology that is ingrained in our day to day work life becomes as natural as breathing. It is easy to forget that our words can sound like a foreign language to the non-medically trained ear.
“Do you have any questions?”
During my nursing career, I have presented lectures to countless nurses and doctors, as well as patients and their families. One of my favorite topics is two-way communication skills. Not surprisingly there is quite a disconnect between what health care providers think their patients understand and what they actually do understand. Often I will start off by assessing the group’s computer literacy. As it turns out, most people fall into the “reasonably competent”’ and “basic skills” categories. Then I ask the people who do not consider themselves computer experts to think about how they feel when they call the IT help desk. There are usually groans and laughs from the audience. I hear comments ranging from, “My IQ drops to single digits,” (this from a world renowned surgeon) to, “I had no idea what to ask and could not even understand the IT technician’s questions,” to “I hate calling them. I feel so dumb!”
This is exactly how many patients and caregivers feel when they interact with their health care provider. We as health care providers have spent years learning our jargon and yet expect patients and their caregivers, who often are under stress, to understand what we are saying, without being medically educated. Most health care providers always ask at the end of a visit, “Do you have any questions?” and often receive silence and a bewildered look in response.
Miscommunication causes health care mistakes
That lack of effective communication among health care providers and patients and their families can be not only frustrating, but dangerous as well. Health care mistakes are the third leading cause of death in the US. That does not mean health care providers are incompetent, it means there is a widespread problem with communication among providers themselves and among health care providers and patients. In order to have effective, seamless medical care with great outcomes, health care providers need to be sure we are all working from the same playbook, and that we all know what the playbook means.
If you have a hard time understanding what your provider means, do not be afraid to speak up and ask them to explain. Remember, he or she might not be aware of the fact that they are using a lot of medical jargon that an average patient does not understand. Remind them of this.