I know that I need to bring this to
everyone's attention. I started getting ideas when I read
this blog
by Nancy Finn. Right topic and the discussion is needed about health
literacy or as she says – healthcare literacy. This is an area
needing attention since it affects about one-half of the US adult
population. After reading Nancy's blog, I did a search for National
Health Literacy Day hoping that I might find something. Nothing for
health literacy was located. There is a literacy day in the world
that is organized by UNESCO and it is on
September 8 of each year.
It began in 1966. In 2007 and 2008, the emphasis was on “Literacy
and Health.”
While health or healthcare literacy
depends on literacy, I could find nothing for a National Health
Literacy Day. I did find something about Health Literacy Month, but
this was started by
Helen Osborne and does not have national
recognition. She is trying to have the month of October as health
literacy month. There are minimal efforts by a few others, but
nothing that is getting recognition.
Other than a few people blogging about
health literacy or healthcare literacy, why is this not a topic for
more earnest discussion and a wider topic for blogger efforts? True,
without the medical professionals participating, this will be a very
one-sided conversation. The professional organizations are putting
out information to encourage physicians to work to
improve communications, but most doctors are so restricted in the time they
have with patients that health literacy takes a back seat. Somewhere
in the conversation, there has to be an answer. Is it going to
require volunteers?
In some hospitals, there are people
designated to talk with patients being discharged to make sure they
understand all instructions and can repeat them back. When the
patient is unable to talk, normally a family member must be present
or a friend that can or will be assisting in the care. They in turn
must be able to communicate with the person doing the discharge for
the patient. Most doctor offices do not have the financial ability
to have someone on staff to deal with this, although this should be
made part of office staff positions. Even doctors working for the
hospitals do not have anyone that is available or capable for
communications with the healthcare illiterate. So, in many ways our
broken healthcare system does not care about patients that are not
health or healthcare literate.
Another problem seldom mentioned is the
problems with patients that lack healthcare literacy. Most are very proud people
and do not want assistance even though they do not understand what
the doctor has told them. Some will reach out for help and are
totally ignored by the doctor's staff. I saw this happen one
afternoon in the hospital doctor's complex. An elderly man was
asking what the papers said that he was handed by the doctor. The
nurse just said he was done with his appointment and he should leave.
He turned toward me with tears in his eyes. Since I was done
checking out after my appointment, I asked the person behind the
counter if he had checked out and she said yes. I asked him if I
could help and he handed me his stack of papers – six in total
including two prescriptions. The nurse saw him hand the papers to me
and came over and took them away from me and ushered him out while
scolding me that HIPAA prevented me from looking at his papers.
HIPAA means the Health Insurance
Portability and Accountability Act of 1996 (HIPAA).
I, of course, knew something was wrong
and had correctly guessed the person could not read. In the hall
outside the office complex, the man turned to me and said, “I can't
read.” I asked him how he had gotten here and he said a neighbor
had driven him and would be waiting in the car for him. We agreed we
should tell this person and we went outside. The neighbor saw us
coming and came toward us. I explained what had happened and we
needed to go back in and I was going to take them to an office where
I knew we could get help. When we arrive at the office, I explained
what I had been told and that the person could not read and was
asking for help to understand what all the papers meant. I explained
the attitude of the nurse and what she had told me. I saw from a
look on the secretary's face that she was upset that this had
happened. She immediately called her boss and asked him to come out
of his office.
When he saw me, I could see him cringe.
The secretary said this was something he needed to deal with
immediately. I repeated everything and the person said he did not
know how to read and was just trying to understand what the papers
were saying. His neighbor said who he was and that he did not even
know this, but that it explained many things. He said that he would
be able to take care of this when he understood what the papers were
all about. The administrator looked at me and said, “you brought
me a problem that needs being taken care of and I will.” I said
thank you to him and turned to leave. Before I had completely
turned, a strong hand grabbed my arm and I found myself in a bear
hug. The man was crying and trying to thank me at the same time.
His neighbor said that now that he was aware of things, he would not
let this happen again. The administrator said that he would see that
the papers were understood and discuss with them other papers that
may be needed to allow the second person to be present at future
doctor visits. He also stated that the nurse would be made aware of
the correct HIPAA rules and also of the problem she caused everyone.
That evening I received two phone
calls. The first was from the administrator to let me know that the
situation had been resolved and that the man's wife had always
covered for him, but had died the previous month. He said that they
would be getting papers to allow two people to be present at all
doctor visits, as his neighbor could not always be present. He also
said that he had given my number to the neighbor so be expecting a
call from them. He had also given them my name and then gave me
their names, which I did not have – just their nicknames. As it
turns out, even the doctor was not aware he could not read, but now
does. The administrator said this was a good lesson for all doctors
and that all had been made aware of literacy problems as well as
healthcare literacy.
Yes, I did hear from them about
half-hour later and the elderly person is not that much older than I
am, but had never been in school as he had been overseas during his
youth and his parents did not believe in school. He explained what
the administrator had told them about me and what a pain in the
backside I could be, but this was one time I had done the right
thing. They both thanked me for being concerned enough to want to
help when I could have walked away. I just said that when the nurse
said what she did, it made me angry and I would have helped for sure
then, as many use HIPAA as a defense for too many things. I said
that once he had handed me his papers, he had made a choice, and
HIPAA no longer applied. Both said the administrator had said this
as well, but appreciated that I had brought them to him. The
neighbor said the administrator told both of them to report any
problems caused by staff about either of the two people that would
accompany him. I said to make sure they did. They both said that
now that they knew where the office was and how he was treated by the
administrator, he would not be hesitant to stand his ground.
I did learn one thing that is important
to me. I knew there are people that cannot read, but had not
realized that I would ever be helping one.
The blog tomorrow will have further
information and a request.
