by Robert Rodvien, MD
When a person is told that they have a serious illness, they are similar to Alice falling down the rabbit hole.
They enter a bewildering new world of discussions, tests and treatment programs that must be navigated while maintaining a job, life obligations, and relationships with friends and family. Just when a person needs more resilience to stress, anxiety can occur. The ability to function is often diminished in such a state, and, like Alice, many begin to grope for solutions. Patients, family members and friends begin to rely on anecdotes. Others find hope-based messages more acceptable than evidence-based ones. Some patients are willing to do anything that appears constructive even if there is no evidence of success.
Some patients seek to become experts in their field of illness and venture on-line to do so, but entering the world of medicine on-line often creates misguided but nonetheless strongly held beliefs. Much of the accessible material is jargon and advertising rather than unbiased information. Web sites and brochures are rife with marketing language to promote a hospital, company or pharmaceutical product, leaving many who seek information as wary consumers instead of informed patients.
This combination of illness, medications, misinformation and anxiety can paralyze information retention. Patients often retain very little from conversations with their physician, and often do not possess the health literacy to absorb the educational literature they find. Material in the office may be scanned for tables, charts, or pictures. It is not clear how often the material is read.
According to the American Medical Association, health literacy is “a stronger predictor of a person’s health than age, income, employment status, education level, and race.” Yet the average person in the United States reads health-related material at only the fourth grade level. A Department of Education study in 2006 showed that 36% of U.S. adults have basic or below basic literacy skills in the area of health care.
As physicians, we need to find other ways to help patients who need information about issues surrounding illness. Podcasts can inform people about health, illness, and treatment. You know your practice. If you are repeating information to dozens of patients about back pain, hypertension, anxiety and viral sore throats, you can make podcasts on these subjects, allowing you to choose the basic points you want people to know and to do it succinctly in a manner that people can re-listen as often as they want. Physician messages, repeated to patients in the comfort and privacy of the patient’s home, are an excellent way to provide care to patients.
With podcasts available, patients can have questions and you can respond with information, but then direct the patient and family to the podcasts, saving your own office time. Podcasts can relate the three or four important issues in carefully chosen but casual terms. You can record your own podcasts or you can review the related podcasts others have available to you on the web.
Podcasts can cover many areas beyond the basic illnesses such as hypertension mentioned above. Podcasts can address practical issues, such as how to prepare for an office visit, what to expect from the health care delivery process; how to deal more efficiently with insurance companies; how to tell a young child you are ill; and how to cope with friends who make painful statements..
Podcasts as an adjunct to face-to-face care, can promote better care and outcomes, reduce anxiety, and help patients live more productive and meaningful lives while undergoing treatment, facing diseases that interfere with their desired life-styles or worse, shortened life spans. We as health care professionals need to aggressively use all the educational tools available to us. Audio podcasts may be one small but very significant step in the right direction.
Robert Rodvien is a hematology-oncology physician and Executive Director of Smarter Medical Care.
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