Work With Me, Doc

Maureen Larkin, for HealthLeaders Media, August 28, 2008

Have you seen the report that says "illiterate" healthcare consumers cost the United States more than $100 billion each year? It's a frightening number, and even scarier when you consider this figure doesn't include the costs of poor outcomes resulting from a patient's lack of a basic understanding of their health and treatment options.

So I guess it shouldn't surprise me to hear the industry talking about the need to increase the health literacy rate of consumers. Patients have to be "trained" to talk to their clinicians, some say. They must educate themselves about common medical terms and think ahead about the questions they want to ask about their diagnosis and treatment options. A "literate" patient will go a long way to solving the quality issues that plague our healthcare system, they say.

But I've got to ask: Why is it my responsibility as a patient to educate myself on something that my doctor already knows? Why can't my doctor—who is already well educated in the subject—take the time to explain my condition to me in a way that I will understand?

Don't get me wrong. I'm not saying patients should sit back and let the doctor make all of their healthcare decisions. I'm all for patients being involved in their care. In fact, I like to think that I'm one of these engaged patients. When I or someone in my family receives a diagnosis, I'm immediately online looking for information that will help me understand it. But I don't believe my 30 minutes of Internet research will make me an expert. I use what I find online as a guide to help me ask the right questions. When there's a healthcare decision to be made, I want an educated, experienced healthcare professional to help me make the right choice.

Physicians have years of classroom and on-the-job training. They're put through the rigors of residencies and fellowships and have worked in various parts of the hospital to gain a complete understanding of the conditions that I and other patients may present. In my mind, this experience has made them experts in their field. So the idea of "training" patients to talk to their physicians seems a bit absurd. Why does making the right decision in healthcare fall strictly on the shoulders of the patient? Don't doctors already have the knowledge needed to help patients make the right decision?

The problem isn't just that patients lack an understanding of basic medical terms. It goes deeper than that. Our healthcare system isn't designed to give physicians the time to sit down, educate, and counsel patients about their illnesses and treatment options. Patients often complain that their doctor spoke a lot of "medicalese" and left the room before they had a chance to digest the given information. This situation is all too common, and one that, when repeated time and time again, does little to help patients become more interested and involved in their own care.

Improving patient engagement and understanding isn't just a job for the patient—but one for the entire healthcare industry. Physicians need to be encouraged to spend time with patients and translate these medical terms that members of the general public just don't understand. In short, doctors need to speak the language of the patient. Doing so will eliminate the fear and intimidation that many patients face during an office visit and encourage them to get more involved in their own care.

The secret to giving patients a higher quality healthcare experience doesn't fall on just the patient. Quality healthcare requires a partnership between patients and providers. All of us—patients and providers—have some work to do.

Maureen Larkin is quality editor with HealthLeaders magazine. She can be reached at
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