Here’s the scene. You’re in your health provider’s office to receive results from recently taken medical tests. Your doctor is perched on a stool in front of a computer that apparently contains everything there is to know about your physical health and wellness. The doctor says, “Mary Lou, I think what we have here is malignant.” Seems like a benign enough statement, except it is not benign, it’s “malignant.”
But what if you do not know what the word “malignant” means. Studies have shown that 18 percent of patients do not understand what that word means. They don’t know malignant means cancerous. The same Harvard-based studies indicated 13 percent of people don’t know what “terminal” means, and a whopping 35 percent don’t understand the word “orally.”
Think about it this way. When a mechanic tells you something is wrong with your car’s shift differential, you may have no idea what he’s talking about. And as long as he fixes the problem, it doesn’t really matter that you understand how he did it. But when it comes to our own bodies and our own health, we need to understand exactly what’s going on.
If these illustrations make you think a bit more about physician-patient communication than you usually do, check out www.AskMe3.org. It clearly outlines three important questions we need to ask when we meet with a health provider.
First question: “What is my main problem?” I recall leaving a clinic with my father-in-law after he had been told he had lung cancer and less than six months to live. As we exited, he turned to my husband and said, “That went well, don’t you think?” Granted, Grandpa Johnson was over 80 years old at the time, with significant hearing problems and early-stage dementia, but that experience will be forever etched in my mind as a reminder of the challenges in communication with hard-to-hear messages, at any age, and the special issues with older adults who have sensory loss and memory difficulties.
Second question: “What do I need to do?” Here’s another story that illustrates the challenges. It involves a woman, newly diagnosed as a diabetic, whose condition required daily insulin injections. She was encouraged to practice on an orange, which she did. But she ended up being discharged from her hospital stay believing she had the option of injecting her daily insulin into an orange — which she could then peel and eat.
Third question: “Why is it important for me to do this?” We are more likely to do something if we understand the reasons for doing it. Maybe another version of that question is: “What happens if I don’t do what you recommend?”
The topic here is “health literacy,” which can be defined as “the degree to which individuals, of any age, have the capacity to obtain, process and understand basic health information and services in order to make appropriate health decisions.”
Sometimes communication around a health diagnosis becomes a bigger problem than the issue itself. Revisit the example above describing the diabetic woman eating a sugar-filled orange on a daily basis and you will understand completely.
Sharon Johnson is an associate professor emeritus, Oregon State University, and the author of “How Gray is My Valley: Enlightened Observations About Being Old.” Reach her at Sharon@agefriendlyinnovators.org.