Miscommunication about healthcare is epidemic. Nine out of 10 people don’t fully understand or remember what to do after a doctor visit. More than 40 percent of people don’t fully understand or remember how to take medication or care for themselves after they leave the hospital.
The consequences can be devastating. Thousands of Americans are injured or die each year because written or verbal communication about healthcare isn’t clear or because they don’t understand the information or its importance.
“Clear communication is one of the most powerful tools you can use to stay healthy,” says Julie N. Baker, of Cleveland Clinic’s Office of Patient Experience. In fact, how well you and your providers communicate about your care — called “health literacy”— is the greatest predictor of how well your care will go.
Health literacy is called the silent crisis because healthcare providers can’t always tell whether or not patients understand.
Lost in translation
Health literacy has nothing to do with your level of education, income, job or race. Medical terminology is a foreign language to most of us, but even those in the medical field may not process what they hear during a health crisis.
Anyone can become confused about what to do after discharge or an appointment — especially when we’re expected to manage increasingly complex care at home.
Stress hinders our ability to listen, to process what we hear and to recall it. “Stress can reduce our thinking ability by about three to four grade levels,” says Ms. Baker.
Pain, surgery and the side effects of certain medications can further confuse communication.
Listen to your gut
The solutions are basic: Trust your instincts, and take an active role in your care.
“Don’t be embarrassed to ask questions if you feel confused or to voice concerns if something just doesn’t feel right,” says Ms. Baker. Remember that nine out of 10 people have been in your shoes.
Here are 6 tips for ensuring safer care for you and your loved ones:
1. Speak up — and be heard. If you have new information, even a minor change in symptoms, tell your doctor. “Doctors aren’t mind-readers. They need your input,” says Ms. Baker. Don’t say you understand if you don’t; you may be taken at your word. If your doctor seems busy, say: “I want to understand, but I feel rushed.” Most doctors will stop and take time to explain things. If not, ask to speak to the physician assistant or nurse.
2. Don’t trust your memory; write it down. Before a doctor’s appointment, write down your questions and concerns, leaving space for the answers. At the office, write down your doctor’s answers; ask your provider to draw a diagram if that will help.
3. Bring a second set of ears. Ask a trusted relative or friend to go with you to an appointment to make sure you remember and understand everything. This is critical when you are being discharged from the hospital, when an appointment is especially important and when you are under stress.
4. Follow directions. Many people don’t understand how important it is to take medication exactly as prescribed and to follow all directions for care. If you have questions or if something you’re supposed to do doesn’t seem right, call your doctor’s office or pharmacy. “Don’t guess — you’re playing with your life,” says Ms. Baker.
5. Master your medications.
- Get smart — Know which medications you need and why. Bringing your medications to doctor’s appointments is often helpful.
- Look at labels — Make sure it’s your name on prescriptions, and that drug names and dosages are correct, before you leave the pharmacy. Human and computer errors do happen; some medications sound or look alike.
- Take it well — Know how to take your medicine. For example, a plastic dropper (syringe) is safer than a teaspoon for precisely measuring liquid medicine.
- Make a list — Give your doctor and pharmacist a list of all your prescription and over-the-counter medicine and supplements.
- Never double up — Never finish old medication if your new medication replaces it.
- Don’t let cost stop you — If you can’t afford medication, tell your provider. You may be able to get a full or partial discount. “Your doctor prescribed it because you need it,” says Ms. Baker.
6. Don’t rush transitions. You may be eager to leave the hospital, but vital information can get lost in the shuffle. “Discharge is a dangerous time,” says Ms. Baker. So is being moved to another unit within the hospital.
In either case, ask for a copy of your discharge summary. If you’re going to a new unit, double-check that they have the correct treatment plan and medication list. If you meet resistance, politely explain, “I want to be able to understand my care.” Take any problems to the Nurse Manager — your feedback will be confidential.
If you’re being discharged to your home, make sure you know when to start on medication and why, and whether your pharmacy carries it.