Due to my interest in practicing medicine in addition to illustrating it, I signed up to shadow some clinicians and volunteer at a local community center in Chicago this semester. A few days ago I shadowed a doctor who works the evening shift for family medicine. Dr. W, I’ll call him, is a great family doctor because of the effective way he communicates medicine and health to his patients.
Many of the patients at the clinic have zero health insurance. Many of them also don’t have the time, money, education and health literacy to always get the best care, not to mention to manage their own health. Health literacy has been described as “the ability to understand and act on health information.” (Jibaja-Wiess, 2007) I’m curious if the health literacy of a patient is actually related to how healthy they are. Because we all know that donuts are bad for us due to the fat content and hardly any nutritional benefits, yet we eat them! (or I do at least, any chance I get) Apparently our country runs on donuts.
In one instance, Dr. W treated a young patient with a history of anemia who was having dizzy spell during sports practice. (I’m maintaining anonymity with names, gender and other specifics for privacy purposes.)
Dr. W asked the patient if they had been taking the 3 iron pills prescribed to them a day, and the patient responded, “not really.” He found that the patient was only taking one, maybe two pills per day. This was a bright high school student with an education that probably included basic sciences. But the patient didn’t take all three pills because they didn’t have a firm grasp of the point of taking them.
Dr. W asked the patient if any doctor had every explained to them how the iron pills were related to the dizzy spells. The patient said no. So he spent about 5 minutes explaining the role of iron as a carrier of oxygen in the circulatory system, and how feelings of dizziness and weakness directly correspond to the low levels of oxygen being delivered to the patient’s muscles, tissues and brain.
Afterwards, the patient said, “that makes so much sense!” So, in the ten minutes it took to treat the patient, Dr. W had used science to convince the patient to take their pills. It was like a light switch being turned on.
The problem is that many doctors don’t take the time (or have the time) to explain the science behind the health to their patients. Some health care workers hand out informational sheets that, according to Dr. W, end up “lining the bird cages.”
One alternative to teaching patients about their disease is something like a disease management program in the form of a DVD or computer interactive. Management programs can teach patients about their condition and how to treat it.
My masters project will be to create some 2D animations for a diabetes management DVD, for low health literacy patients. The animations will, as clearly as possible, describe the role of insulin and glucose in diabetes. The point is to show patients what their medication does and why it’s essential to warding off diabetes. It will eventually be implemented on computers in clinics and hospitals so that patients can see and learn directly before or after their doctor’s appointment.
Lucky for me, shadowing in the clinic is a great way to see where exactly a disease management program can fit into community health care!
Jibaja-Weiss, M. L. (2007). Utilizing computerized entertainment education in the development of decision aids for lower literate and naive computer users. Journal of Health Communication, 12(7), 681-697.