Communicating Effectively
with
Health Care Providers
Just What Did the Doctor Order?
“Try both aleve
2pills bid with
flexeril at hs, if not
better see me
next week.”
2
What is Your Experience?
3
Communication Breakdown
House episode clip…
http://www.youtube.com/watch?v=XjkCl3-PId8
4
Why are We at Risk?
• Reliance on the written word for patient
instruction
• Increasingly complex healthcare system
- More medications
- More tests and procedures
- Growing self-care
requirements
- Esoteric language
5
Health Literacy:
A Universal Problem
12%
Proficient
Only 12% of adults are
proficient in
understanding health
information
Source: National Assessment of Adult Literacy (NAAL), U.S.
Department of Education, 2003
6
What Can You Do?
#1: Ask Questions
7
Questions Are the Answer
http://www.ahrq.gov/questionsaretheanswer/media/QATA_restaurant30sec.wmv
8
Questions Are the Answer
http://www.ahrq.gov/questionsaretheanswer/media/QATA_phone30sec.wmv
9
Questions Are the Answer
Have you asked your doctor a
question and not understood
the answer?
Have you stopped yourself
from asking a question
because you were
embarrassed or scared?
10
Questions Are the Answer
• Asking questions helps put you in charge of
your health care
11
Did You Get a Prescription?
Ask…
•
•
•
•
•
•
•
•
•
What is the name of the medicine?
How do you spell the name?
Can I take a generic version?
What is the medicine for?
How am I supposed to take it?
When should I take it?
How long do I need to take it?
Can I stop taking it if I feel better?
What are the side effects?
12
Did Your Doctor Suggest Surgery?
Ask…
•
•
•
•
•
•
Why do I need the surgery?
What kind of surgery do I need?
What will you be doing?
What are the benefits and risks?
Have you done this surgery before?
How successful is this surgery?
13
What Can You Do?
#2: Be Prepared
14
Create a Visit Plan
• Medicines
• Symptoms
• Lifestyle Changes / Life
Events
• Concerns
• Questions
15
Make a List of All Your Medicines




Prescription medicine
Over-the-counter medicine
Vitamins
Herbal supplements
Include…
•
•
•
•
•
What you take
How much
How often
What it is for
Medication allergies and any bad side effects you
have had
16
Make a List of All Your Symptoms
 Physical
 Thoughts & Feelings
Include…
•
•
•
•
•
•
What the symptom is
When it started
When it happens
How long it lasts
How often if happens
If anything helps or makes it worse
17
Don’t Forget Lifestyle and Life Events
 List any assistive devices
Things that help you see, hear, stand, balance, and get around
 Lifestyle changes
Changes in activities, ability to function or do things
 Life events
Retirement, death of a loved one, moving, financial change
 Lifestyle
Tobacco use, alcohol consumption, social activities, physical
activity
18
Write Down Concerns & Questions
 Remember to bring
along your question
list
 Rank your list of
concerns & questions
 Talk about the most
important ones first
19
What Can You Do?
#3: Be Open and Honest
20
Be Open and Honest
Do not just say what
you think the doctor
wants to hear
The doctor cannot
help you if you do not
talk about what is
going on
21
Sensitive Topics
Driving
Incontinence
Alcohol Use
Grief and
Depression
Falling or
Fear of Falling
Sexuality
Family
Problems
Memory
Problems
22
What Can You Do?
#4: Make Sure
You Understand
23
Practice in Front of Your Doctor
“What I hear, I forget; what I see, I remember;
but what I do I understand.”
~ Confucius in 451 B.C.
24
Make Sure You Understand
• Always ask about anything that is unclear
• Repeat what your doctor says in your own
words
• Take notes
• Bring a friend
• If you still don’t understand, ask again!
25
What Can You Do?
#5: Know the Answer
to Three Questions
26
Know the Answer to 3 Questions
What Is My
Main Problem?
Diagnosis
What Do I Need
to Do?
Why is it
Important for
Me to Do This?
Treatment
Context
27
Ask Me 3 Example
The Doctor Says….
“Your LDL is elevated and your HDL is lower than we
would like. You need to cut back on saturated fatty
acids and trans fats and begin an exercise regimen.”
28
Do You Know the Answer to…
What is my main problem?
Answer: High Cholesterol
29
Do You Know the Answer to…
What do I need to do?
Answer: Watch what I eat, stay away from
fatty foods and be more active
30
Do You Know the Answer to…
Why is it important for me
to do this?
Answer: Having high cholesterol can lead to
problems with my heart
31
What Are the 3 Questions?
What Is My
Main Problem?
Diagnosis
What Do I Need
to Do?
Why is it
Important for
Me to Do This?
Treatment
Context
32
After Your Visit
• Review what you need to do
• Tell a friend or family member
what the doctor told you
• Follow through with any
instructions you received
• Know where to go if you have
questions or want more
information
33
For More Information
• Additional information about talking with your
health care providers can be found at:
– NIH Senior Health: Talking with Your Doctor
• http://nihseniorhealth.gov/talkingwithyourdoctor/toc.html
– American Medical Association Guide to Talking to Your Doctor
• Check it out at your local public library!
– AHRQ: Questions are The Answer
• http://www.ahrq.gov/questionsaretheanswer
– Ask Me 3
• http://www.npsf.org/askme3
34
Questions?
35
“Understanding
is a two-way street.”
Eleanor Roosevelt
36
Created By:
Alisha Ellwood, MA, LMFT
Chair, Minnesota Health Literacy Partnership
Project Manager, Blue Cross and Blue Shield of Minnesota
Additional health literacy resources are available from the Minnesota Health Literacy
Partnership Website at: http://www.healthliteracymn.org
Last Updated: August 18, 2010
The Health Literacy Program for Minnesota Seniors (HeLP MN Seniors) is brought to you by the University of Minnesota Health
Sciences Libraries and the Minnesota Health Literacy Partnership. Funding was provided through a subcontract from the National
Library of Medicine National Network of Libraries of Medicine under contract number N01-LM-6-3503.
This work is protected by an Attribution Share Alike (cc by-sa) license. Under this license, others are able
to remix, tweak, and build upon the original work even for commercial reasons, as long the original
source is cited and derivative works are licensed under identical terms. For more information, see:
http://creativecommons.org/licenses/by-sa/3.0
37