October 26th, 2010 by Jennifer Shine Dyer, M.D. in Better Health Network, Health Policy, Health Tips, News, Opinion, Research
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When it comes to understanding medical information, even the most sophisticated patient may not be “smarter than a fifth grader.”
In one of the largest studies of the links between health literacy and poor health outcomes, involving 14,000 patients with type 2 diabetes, researchers at the University of California San Francisco and Kaiser Permanente found that more than half the patients reported problems learning about their condition and 40 percent needed help reading medical materials. The patients with limited health literacy were 30 to 40 percent more likely to experience hypoglycemia — dangerously low blood sugar that can be caused if medications are not taken as instructed — than those with an adequate understanding of medical information.
Now, federal and state officials are pushing public health professionals, doctors, and insurers to simplify the language they use to communicate with the public in patient handouts, medical forms, and health websites. More than two-thirds of the state Medicaid agencies call for health material to be written at a reading level between the fourth and sixth grades.
A new federal program called the Health Literacy Action Plan is promoting simplified language nationwide. And some health insurers, doctors’ practices, and hospitals have begun using specialized software that scans documents looking for hard-to-understand words and phrases and suggests plain-English replacements. Read more »
September 7th, 2010 by StevenWilkinsMPH in Better Health Network, Health Tips, Opinion, True Stories
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A neighbor of mine was diagnosed with breast cancer about the same time my wife was being treated for lung cancer. I saw my neighbor the other day for the first time in several years. I asked her how she was doing. She said great. In turn I asked her how her PET/CT exam looked. PET/CT scans are often done to make sure that one’s cancer hasn’t spread. My wife gets one every year.
My neighbor told me her doctor never told her she needed one, that mammograms would suffice. She went on to say a friend had also recently asked her if she had a PET/CT as well. “Maybe I should ask my doctor,” she told me. That was the same response she gave me the last time I raised the subject two years earlier: “I should ask my doctor.”
So Why Don’t People Ask More Questions?
My neighbor is not alone when it comes to asking their doctor questions. In an earlier post, I cited research which found that patients ask their doctor an average of two important questions during the office visit. According to researchers, there are five reasons why people don’t ask their doctor questions. Read more »
*This blog post was originally published at Mind The Gap*
September 1st, 2010 by Toni Brayer, M.D. in Better Health Network, Health Policy, News, Opinion, Research
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In a surprising report from the Archives of Internal Medicine, we learn that most hospitalized patients (82 percent) could not accurately name the physician responsible for their care and almost half of the patients did not even know their diagnosis or why they were admitted.
If that isn’t enough, when the researchers queried the physicians, 67 percent thought the patients knew their name and 77 percent of doctors thought the patients “understood their diagnoses at least somewhat well.” I would call that a pretty significant communication gap.
Ninety percent of the patients said they received a new medication and didn’t know the side effects. Although 98 percent of physicians thought they discussed their patients’ fears and anxieties with them, only 54 percent of patients thought they did. Read more »
*This blog post was originally published at ACP Internist*
August 31st, 2010 by Happy Hospitalist in Better Health Network, Opinion, True Stories
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What do you do when doctors and nurses don’t get along? A reader asks for my advice:
Hi Happy,
I have this problem and wanted some advice from someone with more experience dealing with this.
I have been bashed by nurses because they expect me to know all the bureaucratic issues, when you don’t have more than a month in the hospital. I have noticed that nurses get mad, when you give them an instruction they don’t understand, or they aren’t used to, not because you are wrong, but instead, their lack of ignorance, or their narrow process of thought. One example of this is when they laugh at me cause i prescribed a generic medication of a common drug that they weren’t familiar with the generic name.
Days ago, a first-year family doctor was yelled at badly by some nurse because she filled in the prescription chart where she shouldn’t — she didn’t know because no one told her. I have seen that attitude several times from different nurses — they yell in a very unproper manner. Read more »
*This blog post was originally published at The Happy Hospitalist*
August 23rd, 2010 by StevenWilkinsMPH in Better Health Network, Health Policy, News, Opinion, Research
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Accountable Care Organizations (ACOs) figure prominently in the new Patient Protection and Affordable Care Act (PPACA). The concept behind ACOs is that by tying both physician and hospital compensation to outcomes via a bundled fee (say for pneumonia) we can expect to see an improvement in quality and value.
In principal, accountable care makes a lot of sense. Practicality speaking, however, doctors and hospitals must address a huge challenge before they can expect benefit financially. Before doctors can be held accountable for the care they deliver, they must first be held accountable for the quality of their communication with patients.
Take hospital readmissions, which are a big healthcare cost driver today. According to a recent study in the New England Journal of Medicine, 20 percent of all Medicare patients discharged from hospitals were readmitted within 30 days, and 34 percent percent within 90 days. The Joint Commission and others rightly believe that inadequate communication between physicians — as well as between physicians and patients — is a major contributing factor. Read more »
*This blog post was originally published at Mind The Gap*
