Dr. J. Fred Ralston Jr., who is part of a busy private medical practice in Fayetteville, Tenn., regularly hands his patients small, brightly colored cards written at a fifth-grade reading level that explain facts about smoking and how to quit.
The cards, also available in Spanish, have proven so useful in improving health literacy and communication with patients that he recently ordered hundreds more for conditions like hypertension, diabetes and depression. “It’s an opportunity for the ’under-the-gun’ physician to help improve the quality of care,” he said.
The 4-by-6-inch “Health Tips” cards — a project of the American College of Physicians (ACP) Foundation — are just one small attempt to remedy a vexing and often hidden health care problem: Patients frequently either forget the information their doctors give them, or recall the information incorrectly.
In fact, people forget 40 percent to 80 percent of the information they’ve been told by their doctors by the time they walk out of the office, according to a 2003 report in the Royal Society of Medicine Journal. About 90 million Americans have a tough time understanding and acting on medical information, a 2004 Institute of Medicine (IOM) report noted.
It may seem like a minor problem, but groups such as ACP and IOM believe it’s actually a serious hurdle that creates sicker people and higher costs. The ACP Foundation Web site states the “hidden epidemic” of low health literacy “causes needless suffering to millions of patients and families each year — and translates to billions of dollars in unnecessary health care costs.”
There are many efforts to combat it. In 2006, the IOM created an ongoing Roundtable on Health Literacy to discuss solutions. The National Library of Medicine and the ACP Foundation created a free medical Web site for patients who are increasingly using the Internet to collect health information that may not always be accurate.
And Dr. Ralston tells patients to “bring your meds for a visit,” so he can sit down with them and their pill bottles to discuss dosage and use.
The ACP Foundation, which has the specific task of improving health literacy, has distributed about 16 million free Health Tips cards to physicians and assistants nationwide in the past two years, and recently added new categories, including depression and high cholesterol.
ACP Foundation Vice President Robert Harnsberger said low health literacy is a real problem that gets even more challenging as patients age. For doctors, he said, the cards provide a brightly colored reminder to “talk in plain English.”
More than 90 percent of ACP doctors said they would personally hand them to patients, he noted.
The hypertension card, for instance, explains it as high blood pressure that, if not treated, can lead to heart attack, stroke and kidney disease. It tells patients to learn how to take their own blood-pressure readings, write their levels down in a notebook each day to share with their doctor, and work with the doctor to map out a blood-pressure goal and a plan to achieve it.
Cards list questions on the back and leave blanks for doctors’ answers. Queries include “How many times a day should I take my medicine?” and, for diabetes, “My hemoglobin A1c level should be ________.”
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