October 05, 2016 — Blog Post
Clarity is Power.
Understandable medical information is essential to America’s future. Without it, in the years ahead we will predictably have difficulties that could have been prevented, which will cause suffering and expense that could have been prevented.
Who wants that, in this era of population health and patient satisfaction ratings?? America needs – and providers need – communities that are as healthy and as happy with their care as they can be.
In this introductory piece for Emmi’s Health Literacy Month, I’ll make the case for the urgency of this movement from three angles.
- Clarity is empowering.
- There’s an art to clear explanation.
- Help families help themselves.
1: Clarity is empowering
The World Bank says empowerment is increasing people’s capacity to take effective action. Makes sense, right? If you can’t do that, you’re powerless, right?
One way to end up powerless is if you get you instructions you can’t understand. It can be exasperating, like assembling do-it-yourself furniture; but in an emergency it can make you panic. Imagine a fire extinguisher you need to use, but you can’t figure it out. You have no power to save yourself.
But imagine another that’s easy to use. Suddenly you do have the ability (the power) to achieve what you need. Clarity is empowering – and sometimes that really matters.
If healthcare providers can increase people’s health clarity, their capacity to take effective action, the potential of every person can be brought to every case, and the best available outcome can be achieved.
2: There’s an art to explanation.
Explaining things clearly takes a mix of skills. Many people can write well and precisely, but clarity requires more: you need empathy for the reader’s mindset, so you know not just what you’re saying, but how it will be heard. (There’s a saying in diplomacy: “I don’t know what I said until I know what you heard.”)
For skeptics of this in medicine, it’s important to note that clarity is the drift of history, and vendors who ignore it are in peril. A generation ago if someone didn’t understand PCs, the “smarter” people would sneer at them, in public or private. Today all computers (and phones and tablets and websites) are much easier to use, so users have more power; and any app or website that’s hard to figure out is doomed.
Indeed, in all those cases, clarity has become a survival skill.
The same thing’s happening with convenience in healthcare, you know … when retail clinics first emerged, the establishment fought back. But there’s no question that convenience is not just convenient, it’s useful – it makes it easier for people to do the right thing, and achieve their potential.
3: Our families need all the help we can get
All this is increasingly important as our elders get older and families find themselves wanting to master all aspects of elders’ well-being. As a Baby Boomer I’m well aware of this.
The Pew Research book The Next America vividly displays the population effect of medicine’s improvements in the past century: we’re not dying in middle age; we’re staying alive to get older. See?
The census data “population pyramid” on the left (1950) shows people dying off in middle page. The 2015 version shows us pretty much not dyin’ – we’re surviving to get old! Hallelujah for good medicine! And on the right, a generation from now, look at all the elders.
The dark bars are the baby boomers, who will be 85+ a generation from now … that top bar says 5% of the country will be 85 and older! (Will the most common hair color be white??) So many of us are not dying that in 2012 surgeon Jon White wrote that 60% of all the humans who’ve ever been 65 are alive today. Talk about unprecedented!
Plus, today’s elders have fewer descendants to care for them. So it’s essential to help those relatives absorb the information they needed efficiently – and reliably.
You can’t discuss literacy without looking at clarity.
Yet time after time, clinicians and public health people worry about our “health literacy,” a term that really bugs me. As someone who worked his whole life in marketing, I knew it was our job to clearly explain what people need to know, so they could do their part. Same in managing our health, right? But so often in healthcare we “blame the victim” – we say “Patients can’t understand this stuff.” In my book Let Patients Help I said it’s perverse to keep people uninformed and then call them uninformed. First, let’s do what we can to each them where they are.
It’s essential that as America ages – as the world ages – we increase patients’ and families’ knowledge and competence, so they’re better able to contribute to every case. So often when patients can’t understand their situation, we hear worries about “health literacy.” I’d bet my house that more often than not, the problem’s in the text or communication, not the person reading it.
Let’s make the most of each person’s potential.
People are different. Not everyone’s as trained as a doctor or nurse – that’s not what we’re talking about. What we are talking about is helping every patient and family make the most of their potential, whatever that is, so they get better care, they’re happier, and they have the longest life they’re capable of.
Clarity empowers better performance … clarity is power.