Health Literacy- fact or fiction?

Lately I've been hearing a lot of people talk about not understanding what is actually wrong with them after going to the doctor. I know the feeling- a lot of times I leave the office in a literally fog (flu season gets me every year!)  and I barely remember the directions he or she has given me to follow, let alone the scientific terms and proper names for all of the parts of my body that were identified.    However, you have to wonder whether or not this is really significant to people getting better  and whether it affects the quality of our healthcare.

Kaiser Health News did an article on this titled Health Care Quality Issues: the Disconnect Between Patients and Experts (which can be found here )  They defined "health literacy" as follows:

This literacy is "the limited ability to understand the technical jargon, the orders, the prescriptions and the forms coming from doctors, nurses, pharmacists and insurance companies. This failure to communicate leads to missed doctor appointments, medications taken incorrectly, instructions ignored — all contributing to worsening health."

Now obviously, this is a real and observable fact. For example- let's say you visit the doctor because you are sick and are coughing up mucus, and the doctor says you have bronchitis. The anatomy of the lung as explained by PubMed Health states that

"When air is inhaled through the nose or mouth, it travels down the trachea to the bronchus, where it first enters the lung. From the bronchus, air goes through the bronchi, into the even smaller bronchioles and lastly into the alveoli."

 Now let's be honest- your doctor will very likely mention at least one of these scientific terms when explaining bronchitis to you, however, how many of us would raise our hands in a classroom if we could point out where in our bodies the bronchioles are?  Probably not many. And at that moment in time when your head is in a fog and you feel like death, understanding the advanced explanation of what is causing your body to feel the way it does at that moment is not high on your list of things to worry about.  All you care about in that moment, is what you are going to do to feel better, and what the doctor can give to you.  

It is for this reason that I always, always, always have a notepad with me when I go to the doctors, to write down what he or she is saying, because I know (and you know)  that once I leave that office, the details are slowly going to leak out of my head while I wander up and down the aisles of Walgreens miserably waiting for my Z-pack prescription to be filled. Completely human- however, this is an issue that is affecting healthcare quality.   There are several issues at play- one issue is that if the patient doesn't fully understand their prognosis, they may later on down the line make mistakes with following the directions on their medication, or follow up treatments.   Even further than this issue, is an overall literacy issue period, with patients being unable to read and understand the directions printed on the medications they are taking.  

Estimates from the article report that this issue could cost up to $7.5  billion dollars annually- no small chunk of change.   But what can be done to insure that this issue is resolved?   speaking from personal experience, I am seeing an increase in the amount of informational pamphlets being handed out after visiting a healthcare facility. In the past three years, I have noticed that I am given handouts when leaving the healthcenter on campus, explaining  details of what I may have visited for (and this is at a college campus, where you would expect those visiting to have reached a certain level of literacy!)   However, the health center is making an important observation: You just can't assume people understand; as a health provider, it is our responsibility to make sure the patients receives and understands all pertinent information given to them.

In a world where everyone thinks they're a doctor courtesy of WebMD, it's easy to forget that not every patient who walks through the doors of a health facility has already been on line and diagnosed themselves, and is only their for a script.  In order to ensure healthcare quality continues to improve and that all patients receive the highest level of care available, healthcare providers will have to continue to keep health literacy in mind when delivering care.