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I know that I need to bring this toeveryone's attention. I started getting ideas when I read this blogby Nancy Finn. Right topic and the discussion is needed about healthliteracy or as she says – healthcare literacy. This is an areaneeding attention since it affects about one-half of the US adultpopulation. After reading Nancy's blog, I did a search for NationalHealth Literacy Day hoping that I might find something. Nothing forhealth literacy was located. There is a literacy day in the worldthat is organized by UNESCO and it is on September 8 of each year. It began in 1966. In 2007 and 2008, the emphasis was on “Literacyand Health.”
While health or healthcare literacydepends on literacy, I could find nothing for a National HealthLiteracy Day. I did find something about Health Literacy Month, butthis was started by Helen Osborne and does not have nationalrecognition. She is trying to have the month of October as healthliteracy month. There are minimal efforts by a few others, butnothing that is getting recognition.
Other than a few people blogging abouthealth literacy or healthcare literacy, why is this not a topic formore earnest discussion and a wider topic for blogger efforts? True,without the medical professionals participating, this will be a veryone-sided conversation. The professional organizations are puttingout information to encourage physicians to work to improve communications, but most doctors are so restricted in the time theyhave with patients that health literacy takes a back seat. Somewherein the conversation, there has to be an answer. Is it going torequire volunteers?
In some hospitals, there are peopledesignated to talk with patients being discharged to make sure theyunderstand all instructions and can repeat them back. When thepatient is unable to talk, normally a family member must be presentor a friend that can or will be assisting in the care. They in turnmust be able to communicate with the person doing the discharge forthe patient. Most doctor offices do not have the financial abilityto have someone on staff to deal with this, although this should bemade part of office staff positions. Even doctors working for thehospitals do not have anyone that is available or capable forcommunications with the healthcare illiterate. So, in many ways ourbroken healthcare system does not care about patients that are nothealth or healthcare literate.
Another problem seldom mentioned is theproblems with patients that lack healthcare literacy. Most are very proud peopleand do not want assistance even though they do not understand whatthe doctor has told them. Some will reach out for help and aretotally ignored by the doctor's staff. I saw this happen oneafternoon in the hospital doctor's complex. An elderly man wasasking what the papers said that he was handed by the doctor. Thenurse just said he was done with his appointment and he should leave. He turned toward me with tears in his eyes. Since I was donechecking out after my appointment, I asked the person behind thecounter if he had checked out and she said yes. I asked him if Icould help and he handed me his stack of papers – six in totalincluding two prescriptions. The nurse saw him hand the papers to meand came over and took them away from me and ushered him out whilescolding me that HIPAA prevented me from looking at his papers. HIPAA means the Health InsurancePortability and Accountability Act of 1996 (HIPAA).
I, of course, knew something was wrongand had correctly guessed the person could not read. In the halloutside the office complex, the man turned to me and said, “I can'tread.” I asked him how he had gotten here and he said a neighborhad driven him and would be waiting in the car for him. We agreed weshould tell this person and we went outside. The neighbor saw uscoming and came toward us. I explained what had happened and weneeded to go back in and I was going to take them to an office whereI knew we could get help. When we arrive at the office, I explainedwhat I had been told and that the person could not read and wasasking for help to understand what all the papers meant. I explainedthe attitude of the nurse and what she had told me. I saw from alook on the secretary's face that she was upset that this hadhappened. She immediately called her boss and asked him to come outof his office.
When he saw me, I could see him cringe. The secretary said this was something he needed to deal withimmediately. I repeated everything and the person said he did notknow how to read and was just trying to understand what the paperswere saying. His neighbor said who he was and that he did not evenknow this, but that it explained many things. He said that he wouldbe able to take care of this when he understood what the papers wereall about. The administrator looked at me and said, “you broughtme a problem that needs being taken care of and I will.” I saidthank you to him and turned to leave. Before I had completelyturned, a strong hand grabbed my arm and I found myself in a bearhug. The man was crying and trying to thank me at the same time. His neighbor said that now that he was aware of things, he would notlet this happen again. The administrator said that he would see thatthe papers were understood and discuss with them other papers thatmay be needed to allow the second person to be present at futuredoctor visits. He also stated that the nurse would be made aware ofthe correct HIPAA rules and also of the problem she caused everyone.
That evening I received two phonecalls. The first was from the administrator to let me know that thesituation had been resolved and that the man's wife had alwayscovered for him, but had died the previous month. He said that theywould be getting papers to allow two people to be present at alldoctor visits, as his neighbor could not always be present. He alsosaid that he had given my number to the neighbor so be expecting acall from them. He had also given them my name and then gave metheir names, which I did not have – just their nicknames. As itturns out, even the doctor was not aware he could not read, but nowdoes. The administrator said this was a good lesson for all doctorsand that all had been made aware of literacy problems as well ashealthcare literacy.
Yes, I did hear from them abouthalf-hour later and the elderly person is not that much older than Iam, but had never been in school as he had been overseas during hisyouth and his parents did not believe in school. He explained whatthe administrator had told them about me and what a pain in thebackside I could be, but this was one time I had done the rightthing. They both thanked me for being concerned enough to want tohelp when I could have walked away. I just said that when the nursesaid what she did, it made me angry and I would have helped for surethen, as many use HIPAA as a defense for too many things. I saidthat once he had handed me his papers, he had made a choice, andHIPAA no longer applied. Both said the administrator had said thisas well, but appreciated that I had brought them to him. Theneighbor said the administrator told both of them to report anyproblems caused by staff about either of the two people that wouldaccompany him. I said to make sure they did. They both said thatnow that they knew where the office was and how he was treated by theadministrator, he would not be hesitant to stand his ground.
I did learn one thing that is importantto me. I knew there are people that cannot read, but had notrealized that I would ever be helping one.
The blog tomorrow will have furtherinformation and a request.
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