To achieve successful patient-centered care, patients and physicians need to understand each other. Physicians need to recognize the specific needs of each patient in the context of medical protocols and standards of care and clearly convey the needed information for shared decision-making. Patients need to understand the meanings of common medical terms, what a diagnosis means, how to weigh the benefits and risks of treatment, and the importance of treatment compliance; in other words, they need to understand a language that may be as natural as breathing to a physician, but may be as impenetrable as a foreign language to a patient.
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May 2019For some patients, it may literally be another language. Adding to the challenges of talking to patients about their health are the changing demographics in the US, which require physicians to attend to language barriers and different cultural norms based on religion, age, gender, sexual identity, and race that influence how patients hear and act on information conveyed in the clinic.
All of this can be defined as health literacy, a concept that has generated considerable attention for the last decade or so. And yet, studies show that health literacy among patients remains low, and physicians are often unaware of this fact. For otolaryngologists, the paucity of data looking at health literacy is testimony to the lack of attention given to this important issue that permeates all of clinical care. “Few studies address health literacy in otolaryngology patients,” said Uchechukwu Megwalu, MD, PhD, associate professor in the department of otolaryngology/head and neck surgery, Stanford University School of Medicine in California. “Consequently, it is not a topic that many otolaryngologists are familiar with.”
It is a topic, however, that is not going away. Low or limited health literacy is linked to poorer health outcomes—particularly in chronic diseases—as well as poor medication adherence, reduced quality of life, increased hospital admission rates, and increased
mortality risk. Not only is this bad for patients, it is challenging to physicians who are increasingly practicing in healthcare systems evolving toward value-based care models that use quality measures to rate physician performance and set reimbursement rates.
If doctors don’t realize there is something wrong and don’t know why they are not getting good patient outcomes, they may not be aware that the patient doesn’t understand them. —Lisa Perry-Gilkes, MD
“Health illiteracy is an impediment to healthcare,” said Lisa Perry-Gilkes, MD, an otolaryngologist with Polaris Medical Group, Emory Healthcare Network in Atlanta. “If doctors don’t realize there is something wrong and don’t know why they are not getting good patient outcomes, they may not be aware that the patient doesn’t understand them.”