May 10, 2011

Who Is Responsible for Patients' Health Literacy?

Patients health literacy is a common theme lately in releases from the various medical associations. All are directed at the patients, caregivers, and healthcare professionals and attempting to provide more information of value to all concerned. What is generating this largess of information? Has all the poor web sites, studies showing lack of reliable information in the internet, or just good public relations finally driving the different medical professional organizations to get active.

Let's hope all of the above is true. Our medical insurance industry is doing almost nothing to help doctors in educating the new patients with diabetes or other chronic diseases. This would take too much from their profits. In many of the new websites and other information, it is the big pharmaceutical companies that are stepping forward to provide assistance as cosponsors or just financial support.

Our medical insurance companies may one day come to regret their greed and refusal to help. Federal and state regulations are already under analysis to determine if the medical insurance industry is violating moral as well as legal obligations in their rejection of patients' needs. I am not sure big pharmaceutical companies are innocent of charges either, considering the Vermont case awaiting a decision by the U.S. Supreme Court later this summer.

Yes, if patients are in cities that have diabetes educators and dietitians, medical insurance will cover a few classes, and then no continuing education for a period of years. Medicare is even less helpful.

The American College of Obstetricians and Gynecologists (ACOG) now states that physicians, nurses, social workers — everyone in the health care field — must make sure that our patients fully understand their health condition and their treatment. They also emphasize the importance of patients taking their medications exactly as directed. We simply can't assume that a patient understands because she/he nods their head or because we think they seem educated.

One important point shows that that they are taking this obligation seriously. They state that asking our patients to repeat back to us what they understand is enormously helpful in making sure they really do comprehend. This can help avoid the stereotype of noncompliant being applied. They also advise using technical translators to assist when there is a language difference.

Read their article on committee opinions here.

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