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Lessons in Health Literacy (cont’d): Physician better than I thought, but still no-pass

It turns out the physician who burst into Dad’s hospital room for the late night exam and diagnostic
interrogation did a better job than I gave him credit for, at least clinically. (See yesterday’s blog).
He held a discussion with other family members at discharge, which I missed. His sketch of the
“explosion” in Dad’s neck made sense to my sister-in-law, an RN. From a health literacy standpoint,
it is likely the medical background knowledge required to understand his sketch is so much a part
of his daily conversations that it seems to him like something everyone knows – but more likely it’s
something only every medical professional knows –not us PhDs and lawyers -
a case of clinician’shyper health literacy.

While this physician had not read Dad’s chart, he did read the x-ray, noted the possible problem, and
checked it out both on rounds and at discharge. At discharge, he confirmed by examination that Dad’s
neck was not fractured and tried again to explain the concern.  So he is a good thorough caring clinician,
who needs to polish up his bedside manner and communication skills – the clinician’s side of health literacy.
My brother, a firefighter and EMT, showed exceptional health literacy by requesting a copy of the x-ray to
take to Dad’s follow up appointment with his personal physician. The doctor provided it on disk. Kudos to
them both.

Back in the ER The day after Dad returned home from the hospital, he seemed to be improving. Then
quite suddenly, he felt too weak to get up out of his chair. His vision blurred. His words slurred. Mom’s
actions in response demonstrated her high health literacy. She went to the refrigerator where she had
posted the FAST Stroke Test. Dad’s slurred speech and his inability to “put his thoughts in his mouth”
led her to call 911. Back in the ER, doctors determined that it was not a stroke, but lack of food
(he can’t chew due to abrasions in his mouth) and anemia from blood loss. Dad was stabilized and
is home again. Mom is dressing his wounds 3 times a day, reading up on nutritional supplements, and
thinking she might qualify for a nursing license. 

Health Literacy – beyond understanding information This experience illustrates that health literacy
is not something you have or you don’t. It is a learned skill set that develops over time with need,
experience and support. Health literacy can only improve outcomes when one acts on information.
And actions, how a person actually uses information for health, are good indicators of that person’s
health literacy.   “Knowing is not enough, we must apply. Willing is not enough, we must do.”

Picture from WebMD Slideshow: A Visual Guide to Understanding Stroke
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