SCGhealth Blog


Questions Your Patients Might Not Know They Need to Ask

Monday, April 09, 2018

By: Audrey Landers

A reader from ConsumerSafety.org let us know this interesting fact: 55% of Americans (almost 178 million people!) regularly take at least one prescription. Unfortunately, we know that low health literacy can keep patients from fully understanding their prescriptions. Not only does health illiteracy cause problems in understanding, but it also affects the ability to recognize what information may not be distributed during an appointment. As SCG Health’s founder, Jen Searfoss, likes to say “you don’t know what you don’t know,” meaning that sometimes patients might not know what they need to ask you when given the opportunity.

Image from Pexels.com

Fortunately they have you: a physician who is ready to go above and beyond by thinking ahead and trying to answer every question before they have it. Here are a few questions these patients might have, if they only knew to ask them:

Why am I being prescribed this medicine?
This question may seem like it doesn’t even need to be asked, after all it’s being prescribed for their high blood pressure, or their arthritis, or the flu that they made their appointment for! But some conditions may require a patient to take many different medications, each of which helps with a different aspect of their ailment. Taking the time to explain what each medication does may keep your patients from feeling that certain prescriptions are useless or unnecessary

How and when will I know if the is medication working? What do I do if I think it isn’t?
Patients sometimes expect magical results from their prescriptions. When you prescribe something new, it’s important to emphasize what the medication will do for them. With some medications, the effect will be noticeable, through easing pain, getting rid of stiffness, or helping to clear up an infection. With others, like for high blood pressure or diabetes, the effects may not be noticeable at all unless there are specific signs they know to look for. Let them know of any subtle signs that show their medication is working. If they believe it isn’t working for them, they may stop taking it or even adjust their dosage on their own so be sure to tell them that even if they feel the medicine is not doing anything, they have to speak to a doctor before they change anything.

What if I miss a dose?
Any missed doses will lower the effectiveness of the medication but each medicine will have different steps that must be taken. Should the patient take a dose as soon as they remember? Or do they double-up on their next scheduled dose? Are there potentially dangerous consequences that come from missing a dose? This information is particularly important if a patient has a history of medication noncompliance.

How do I store the medication?
Will a certain medication become less effective if stored in a humid bathroom medicine cabinet? What medicines need to be kept cool in the fridge? People tend to keep all of their medicine in one area so if a prescription has special storage instructions, the patient needs to know before they pick it up.

What do I avoid while taking this medication?
Medications can have all sorts of unpleasant reactions to things that the average consumer would not expect. While many people will avoid alcohol, physical labor, and heavy machinery depending on the medication, other things they need to avoid are not so obvious. A patient will need to know if their prescription will negatively interact with any over-the-counter medications they might use as well as any supplements. Many people think that anything labeled herbal or natural is automatically healthy, and may not take as much caution as they would with cough medicine or ibuprofen.


Health Literacy -Do Your Patients Understand You?

Wednesday, January 10, 2018

By Audrey Landers

Health literacy is the combination of basic reading and numerical skills that enables someone to understand the health information and services needed for healthy decision making. 

99% of adults in the United States are literate, while only 12% are considered to be proficiently health literate with 14% being considered below basic. What causes this enormous gap? One cause is that the reading level which is required to considered to be literate and health literate are vastly different. In order to be literate a person must be able to read at some level, with no qualifying benchmark for how well they must be able to do so.

The majority of adults read at an eight grade level, with 20% reading at a fifth grade level or below. Meanwhile, most medical documents are written at a tenth grade level. This difference means that even well-educated adults can have difficulty comprehending healthcare and reality is even more grim for those who only have basic literacy skills. 

Those who suffer the most from low health literacy are often those with other disadvantages. Elderly patients who may have trouble with their memory or with understanding new concepts, non-native English speakers and those from low-income families are most vulnerable to the problems that low health literacy creates. Those who are health illiterate are more likely to have difficulty understanding (and taking) medications, less likely to participate in activities that promote wellness and are hospitalized more often.

What can you do to help?

While increasing health literacy may seem like David vs Goliath to most physicians, there are a few things you can do in your own practice to help give patients the opportunity to understand more about their health.

First, by learning how to identify those who may have extremely low health literacy, you can personalize the care you give them to their needs. Here are a few signs to look for:

  • The patient needs help to fill out forms
  • The patient puts off decision making and instruction reading
  • The patient is a chronic no-show
  • The patient has difficulty complying with medication and recommended lifestyle changes

Be aware of your language. Health literacy also refers to a patient’s ability to understand spoken language in medical settings. To make yourself understood in the exam room you should be aware that some words can have very different meanings and implications in “medicalese” verses common English. One example is the word “diet” which to a physician may just mean what food someone eats but to a patient it means going on a diet like atkins or paleo.

Be specific. How many times have you told a patient to “come back if you get worse?” What does “get worse” mean exactly? This question is disastrous when combined with a new prescription that could have side effects that would confuse a patient. Instead, give patients specific symptoms and signs to look for whenever possible.

Use the “teach back” method. After giving a patient instructions on how to perform a task or take medication, instead of asking if they understood you, ask them to explain it back to you. By using this method, you can gauge what the patient understands and will know what exactly they have trouble with if they aren’t getting something.

Make it easy. One common piece of advice for educating patients is to give them a printed handout with the information and instructions they need on it. As mentioned above, most healthcare documents are written at a tenth grade level, meaning that even if you give your patient information to take home they may not be able to fully understand it. To combat this, it is recommended that any patient education material should be written at the sixth grade level or lower. You should also include easy-to-understand pictures and graphics when possible. The US National Library of Medicine has a great guide for writing easy-to-read heath materials.

To give you a general idea of what grade-level writing looks like, I put this blog post through a readability checker and found that it is written at about the eleventh grade level.



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