These are questions to think about:

1.	When you walk out of a doctor’s office after an appointment, how
do you feel about what the doctor told you?  

It depends.  I usually forget to ask them SOMETHING while I am there, so by the time I get to the car, I wonder what that was.  In this case, I feel overwhelmed and maybe worried.  If I am going in for an annoying, recurring but painful kind of thing (like a sinus infection or a UTI) I feel relieved but in a hurry to get out there.  Then I have to go to get the meds, and that's another trip--it's annoying waiting for medication, having to travel to yet another place when you feel SICK.  If it's your child that is sick, it is VERY stressful! 

It would be nice to be able to call the doctor (for yourself that is, not your kids) and say, "Hey!  I have another one of these stupid sinus infections with the same symptoms as last time.  Can you call in antibiotics and if they don't work, I will come in?"  Of course, there has been too much antibiotic abuse for this to happen.  And there are certain medications I would NEVER recommend you do this for (like those for mental illness or diabetes, for example).

2.	What makes it hard for you to understand what your doctor is
saying?

When he doesn't put things in terms I understand.  When he can't translate to me what he knows about medication.  When the instructions are not clear or not included on the bottle.  When he is in a hurry because he knows he has someone else coming in shortly.

3.	Do you ask the questions that you want to ask your doctor? Why
or why not?

See #1.  I try but I always seem to forget a few.  Sometimes, I call back to clarify.

4.	How well do you understand the written brochures that you get
from doctors? Do you use them by looking at them later? Why or why not?

I read the brochures.  However, there is sometimes poor translation from the pamphlet into reality.  For example, if the brochure starts talking about side effects, a patient might look for those side effects and not know if he/she is really experiencing them or not.  I've been in the position of calling doctors about this only to have them say in not so many words, you are imagining it. There are hypochondriacs out there, but dismissing a patient's concerns is not good practice.

5.	What helps to make all of these things easier?

a.  If it's an ongoing illness, frequent, face-to-face meetings with the doctor.
b.  Calling and being responded to.
c.  Explanations of medication brochures.
d.  In-depth discussions on drug interactions and what to look for.
e.  Understanding if the patient is anxious.
f.  For short-term treatments, follow up through email or phone, depending on the patient.

6.	If you could make a list of suggestions for your doctor, or for
the clinic or hospital, what would you say? (These are suggestions for
how they could make it easier for you to understand what is happening
with your health, and what you need to do to stay healthy.)

a.  Have an in-house pharmacy that takes all insurances.  Make sure the pharmacy has access to ALL your current meds to avoid drug interaction issues.  Encourage patients to be consistent in their pharmacy selections, especially if they are taking multiple medications and there is no communication between pharmacies.  (Personally, I think ALL pharmacies, no matter what their corporate affiliation, should be linked to patients' medication histories.)
b.  Don't dismiss patients' comments or questions.  There is a reason why they are asking what they are asking.  You might have to dig a little to get at it.
c.  Acknowledge that patients know their own bodies.  They might not be able to put it in medical terms, but it's the doctor's job to do that.  
d.  Patients often know something is wrong or that something is wrong with their children.  Don't dismiss this.  They might not be able to diagnose, but they can sense something is wrong.
e. Encourage patients to stay informed, especially if they are on medications that can produce strong or negative side effects.  Provide the proper channels to do this.  Online chat groups filled with strangers are not good places to discuss medications and symptoms even though it might make for interesting reading. 



Katherine Mercurio Gotthardt



-----Original Message-----
From: learningdisabilities-bounces at nifl.gov
[mailto:learningdisabilities-bounces at nifl.gov]On Behalf Of Julie
McKinney
Sent: Friday, October 19, 2007 11:05 AM
To: learningdisabilities at nifl.gov
Subject: [LearningDisabilities 1428] Clear communication with
healthproviders


Hello,

Thanks, Rochelle, for that article about clear communication! We are in
the middle of a discussion on the health literacy list about
communicating clearly between patients and health care providers
(including doctors, nurses, radiologists, nutritionists, pharmacists and
many others.) While reading the article, it occurred to me that all of
the strategies suggested for English language learners and students with
learning disabilities would be very helpful for health professionals to
use with their patients.

I think that many health care providers could learn a lot from teachers
who work with adults with learning disabilities, and from those with
learning disabilities themselves. So I want to invite you all to share
your thoughts and experiences in communicating about health and medical
care.

Here is a link to information about the discussion and guest speakers:
http://www.nifl.gov/lincs/discussions/healthliteracy/07healthcommunication.html


Below are some questions to ask yourselves and your learners, and some
guidelines for a writing activity. Please feel free to send in your
thoughts or stories to this list, or you can join the health list
briefly to join the discussion. (The discussion goes through Monday the
22nd, but we always welcome comments at any time!)

Thanks so much,
Julie

**********************
You can find out more about the discussion list, read the recent
discussion, and subscribe (for free) at this link:
www.nifl.gov/mailman/listinfo/healthliteracy 


These are questions to think about:

1.	When you walk out of a doctor’s office after an appointment, how
do you feel about what the doctor told you?
2.	What makes it hard for you to understand what your doctor is
saying?
3.	Do you ask the questions that you want to ask your doctor? Why
or why not?
4.	How well do you understand the written brochures that you get
from doctors? Do you use them by looking at them later? Why or why not?
5.	What helps to make all of these things easier?
6.	If you could make a list of suggestions for your doctor, or for
the clinic or hospital, what would you say? (These are suggestions for
how they could make it easier for you to understand what is happening
with your health, and what you need to do to stay healthy.)

We would like to share stories from adult learners with the health
professionals on the discussion list. These can be about experiences
communicating with health care providers, or challenges in navigating
the health system and environment. We will at some point have a
follow-up to this discussion and highlight more student/patient stories.
We are also collecting them for the Health Page on the ALE Wiki. You can
see what we have so far at this link:
http://wiki.literacytent.org/index.php/Health_Literacy (Click on
"Stories from learners and patients")

Here are some guidelines for a class writing activity for anyone who is
interested:

To write a story:

1.  
Introduce yourself. You can decide what to say, but here are some ideas
of what you could include: 
•	where your home is
•	what you do
•	who lives with you
•	why you care about your family’s health
•	how long you have been studying English or reading and writing. 

2.  
Think of an experience when you were in an appointment, and you walked
out feeling like you did not really understand what happened, or what
you were supposed to do. It could be a doctor’s appointment, or some
other specialist. (For example, getting some kind of test or x-ray, or
meeting with a nutritionist.) Write about what happened, and why you
feel that the information was not clear to you. This doesn’t have to be
long, and you can have your teacher or someone else help with the
writing, but it should be your writing and your own words. It doesn’t
have to be perfect! (No one will check the spelling and grammar. We just
want to hear about your experience.)

*******************************
Thanks again! Please let me know if you do this activity and how it
went!



Julie McKinney
Discussion List Moderator
World Education/NCSALL
jmckinney at worlded.org

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