1. Communicating Effectively with Health Care Providers

2. Just What Did the Doctor Order? “Try both aleve 2pills bid with flexeril at hs, if not better see me next week.” 2

3. What is Your Experience? 3

4. Communication Breakdown House episode clip… http://youtu.be/7X4CoXIdlCA 4

5. 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

6. Only 12% of adults are proficient in understanding health information 12% Proficient Health Literacy: A Universal Problem Source: National Assessment of Adult Literacy (NAAL), U.S. Department of Education, 2003 6

7. What Can You Do? #1: Ask Questions 7

8. Questions Are the Answer 8 http://youtu.be/jfylYtyb8tE

9. Questions Are the Answer 9 http://youtu.be/DTo_KS88D1I

10. 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

11. Asking questions helps put you in charge of your health care 11

12. 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

13. 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

14. What Can You Do? #2: Be Prepared 14

15. Create a Visit Plan Medicines Symptoms Lifestyle Changes / Life Events Concerns Questions My visit plan… 15

16. 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

17. 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

18. 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

19. 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

20. What Can You Do? #3: Be Open and Honest 20

21. 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

22. Sensitive Topics 22 Driving Falling or Fear of Falling Grief and Depression Alcohol Use Memory Problems Family Problems Sexuality Incontinence

23. What Can You Do? #4: Make Sure You Understand 23

24. 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

25. 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

26. What Can You Do? #5: Know the Answer to Three Questions 26

27. Know the Answer to 3 Questions 27 What Is My Main Problem? What Do I Need to Do? Why is it Important for Me to Do This? DiagnosisTreatmentContext

28. 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

29. Do You Know the Answer to… What is my main problem? Answer: High Cholesterol 29

30. 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

31. 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

32. What Are the 3 Questions? 32 DiagnosisTreatmentContext What Is My Main Problem? What Do I Need to Do? Why is it Important for Me to Do This?

33. 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

34. 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

35. Questions? 35

36. “Understanding is a two-way street.” Eleanor Roosevelt 36

37. 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.orghttp://www.healthliteracymn.org Last Updated: April 18, 2011 37 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/3.0http://creativecommons.org/licenses/by-sa/3.0