Health Literacy 101

As a primary care doctor, my job is to serve as a guide, or an advisor, to help patients navigate the healthcare system and to assist them in preventing personal medical pitfalls.  Still, much of their success in terms of health outcomes is dependent on how they approach the healthcare system.  What’s problematic though is that many consumers (ie patients) are unaware of some basic healthcare literacy concepts that help translate to healthy living.  Below are several “inside” tips, facts, and information pieces to aid in an improved navigation of the healthcare system.

Just because you feel good does not mean that everything is normal on the inside.  Even if you are completely “healthy” in your mind, you should be seeing your doctor at least once yearly for a check-up.  There is a reason some labs and tests are deemed “screening” tests, as they pick up things that have no outward physical signs or symptoms.

Trust your doctor and his or her ability to manage your medical issues in your best interest.  If that trust is not there, find a new doctor.

During office visits, be able to clearly express why you are there and what you want to accomplish.  There truly is no such thing as a stupid question, as you are paying the physician for his or her services.  Those services include listening, communicating, and educating.

Have an understanding of your previous medical problems/diagnoses.  Your Past Medical History includes conditions for which you have been treated for, or seen by a medical professional, long-term.  Any previous hospitalizations also count.  If you have had previous surgeries, have a working list of when and for what.

Know your past family medical history.  You should know what medical issues your biological parents, siblings, and children have or have had.  Aunt, uncle, and grandparent information can be useful in the event of certain cancers and hereditary diseases.  Thus, some knowledge of conditions that are prevalent throughout your extended family is important.  And note that when your doctor asks you what kind of cancer has been in the family, he or she is referring to where the cancer started, and not necessarily to where it spread.

Have a working list of your medications and dosages and any medication allergies.  This helps us to better interpret your condition, certain lab results, and future management decisions.

Supplements are medicines too.  You cannot say that you are “natural” if you are taking supplements.  In fact, many dietary supplements are more dangerous than prescribed medications because most have not undergone the rigorous FDA-approval process (that includes clinical trials) that prescribed medicines have.

Be honest about your smoking and drinking history, as it can affect how some labs and tests are both ordered and interpreted.

Be able to express and articulate any physical complaints.  We want to know what it feels like.  “It hurts” or “pain” are not descriptions.  Use words like sharp, dull, achy, stabbing, burning, tingling, etc.  How severe is it?  We want to know when it started and if it is constant or intermittent.  Know what makes issues better or worse, and tell us what you have tried in terms of medications or other alleviating actions.

Have an understanding of basic labs.  Important labs to be familiar with include LDL (good cholesterol), HDL (bad cholesterol), glucose (sugar), A1c (diabetes/sugar control), hemoglobin/hematocrit (oxygen-carrying red blood cells), white blood cells (infection/inflammation fighters), PSA (prostate cancer marker), creatinine (a measure of kidney function) and TSH (thyroid function).

Educate yourself on health topics that are of concern to you and see what your doctor thinks about them.  Do not challenge him or her.  Trust me; unless you went to medical school AND residency AND passed boards, it is unlikely that you have a better working knowledge of health topics than your doctor.  HOWEVER, you could quite possibly be aware of some things that your doctor is not well versed in.  Presenting information in a non-challenging way allows for a productive dialogue.  Just as you do not want the doctor talking over your head, do not try to talk over his or hers.

Myth: Doctors get paid by prescribing you medicine, ordering labs, and/or ordering tests.  We do NOT.  In fact, there are laws that protect against this.  Our compensation comes from what we do in the office (or operating room).  Medicines, labs, and tests do account for a large amount of healthcare costs, but know that we try to minimize these for you (and the system).

Blood pressure, diabetes, cholesterol, mood medications, etc. work when you are taking them and do not when you are not taking them.  It is important to take medications that are prescribed for daily use every day without fail.  Once the medicines bring you to a particular goal level, you still have to take the medicine(s) or else your situation will regress.  Likewise, know that your body will not somehow become dependent or tolerant of such medicines.  Thus, lifestyle modifications remain important as it pertains to being able to potentially lower or stop certain medications.

An infection can be caused by a virus, a bacterium, a fungus, or a parasite.  Certain allergies can cause similar symptoms.  These all require different classes of medicine.

Myth: If you have an infection, you need an antibiotic.  Wrong.  So don’t call or go to the doctor to ask for one.  And please don’t be disappointed if it is deemed that you do not need one.  Antibiotics treat bacterial infections; that’s it.  As above, infectious symptoms can arise from a myriad of sources, not just bacteria.  Also, many minor infections will resolve on their own without treatment.

Bacteria, viruses, fungi, and parasites are living things.  Thus, excessive use of anti-infective agents can lead to resistant organisms.