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Communicating Effectively
with Health Care Providers
Just What Did the Doctor Order?
“Try both aleve 2pills bid with flexeril at hs, if not better see me next week.”
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What is Your Experience?
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Communication Breakdown
House episode clip…
http://youtu.be/7X4CoXIdlCA
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Why are We at Risk?
• Reliance on the written word for patient instruction
• Increasingly complex healthcare system- More medications- More tests and procedures- Growing self-care
requirements- Esoteric language
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Only 12% of adults are proficient in
understanding health information
12%Proficient
Health Literacy: A Universal Problem
Source: National Assessment of Adult Literacy (NAAL), U.S. Department of Education, 2003
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What Can You Do?
#1: Ask Questions
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Questions Are the Answer
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http://youtu.be/jfylYtyb8tE
Questions Are the Answer
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http://youtu.be/DTo_KS88D1I
Have you asked your doctor a question and not understood the answer?
Have you stopped yourself from asking a question because you were embarrassed or scared?
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Questions Are the Answer
Questions Are the Answer
• Asking questions helps put you in charge of your health care
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Did You Get a Prescription?
Ask…• What is the name of the medicine?• How do you spell the name?• Can I take a generic version?• What is the medicine for?• How am I supposed to take it?• When should I take it?• How long do I need to take it?• Can I stop taking it if I feel better?• What are the side effects?
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Did Your Doctor Suggest Surgery?
Ask…• Why do I need the surgery?• What kind of surgery do I need?• What will you be doing?• What are the benefits and risks?• Have you done this surgery before?• How successful is this surgery?
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What Can You Do?
#2: Be Prepared
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Create a Visit Plan
• Medicines• Symptoms• Lifestyle Changes / Life
Events• Concerns• Questions
My visit
plan…
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Make a List of All Your Medicines Prescription medicine Over-the-counter medicine Vitamins Herbal supplements
Include…• What you take• How much• How often• What it is for• Medication allergies and any bad side effects you
have had
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Make a List of All Your Symptoms Physical Thoughts & Feelings
Include…• What the symptom is• When it started• When it happens• How long it lasts• How often if happens• If anything helps or makes it worse
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Don’t Forget Lifestyle and Life Events
List any assistive devices Things that help you see, hear, stand, balance, and get around
Lifestyle changes Changes in activities, ability to function or do things
Life events Retirement, death of a loved one, moving, financial change
LifestyleTobacco use, alcohol consumption, social activities, physical activity
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Write Down Concerns & Questions
Remember to bring along your question list
Rank your list of concerns & questions
Talk about the most important ones first
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What Can You Do?
#3: Be Open and Honest
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Be Open and Honest
Do not just say what you think the doctor wants to hear
The doctor cannot help you if you do not talk about what is going on
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Sensitive Topics
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Driving
Falling orFear of Falling
Grief and Depression
Alcohol Use
Memory Problems
Family Problems
Sexuality
Incontinence
What Can You Do?
#4: Make Sure You Understand
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Practice in Front of Your Doctor
“What I hear, I forget; what I see, I remember; but what I do I understand.”
~ Confucius in 451 B.C.
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Make Sure You Understand
• Always ask about anything that is unclear
• Repeat what your doctor says in your own words
• Take notes
• Bring a friend
• If you still don’t understand, ask again!
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What Can You Do?
#5: Know the Answer to Three Questions
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Know the Answer to 3 Questions
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What Is My Main Problem? What Do I Need
to Do?Why is it
Important for Me to Do This?
Diagnosis Treatment Context
Ask Me 3 Example
The Doctor Says…. “Your LDL is elevated and your HDL is lower than we would like. You need to cut back on saturated fatty acids and trans fats and begin an exercise regimen.”
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Do You Know the Answer to…
What is my main problem?
Answer: High Cholesterol
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Do You Know the Answer to…
What do I need to do?
Answer: Watch what I eat, stay away from fatty foods and be more active
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Do You Know the Answer to…
Why is it important for me to do this?
Answer: Having high cholesterol can lead to problems with my heart
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What Are the 3 Questions?
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Diagnosis Treatment Context
What Is My Main Problem? What Do I Need
to Do?Why is it
Important for Me to Do This?
After Your Visit
• Review what you need to do
• Tell a friend or family member what the doctor told you
• Follow through with any instructions you received
• Know where to go if you have questions or want more information
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For More Information
• Additional information about talking with your health care providers can be found at:– NIH Senior Health: Talking with Your Doctor
• http://nihseniorhealth.gov/talkingwithyourdoctor/toc.html – American Medical Association Guide to Talking to Your Doctor
• Check it out at your local public library!– AHRQ: Questions are The Answer
• http://www.ahrq.gov/questionsaretheanswer – Ask Me 3
• http://www.npsf.org/askme3
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Questions?
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“Understanding is a two-way street.”
Eleanor Roosevelt
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Created By: Alisha Ellwood, MA, LMFTChair, Minnesota Health Literacy PartnershipProject Manager, Blue Cross and Blue Shield of Minnesota
Additional health literacy resources are available from the Minnesota Health Literacy Partnership Website at: http://www.healthliteracymn.org
Last Updated: April 18, 2011
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The Health Literacy Program for Minnesota Seniors (HeLP MN Seniors) is brought to you by the University of Minnesota Health Sciences Libraries and the Minnesota Health Literacy Partnership. Funding was provided through a subcontract from the National Library of Medicine National Network of Libraries of Medicine under contract number N01-LM-6-3503.
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