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PRESIDENT’S
MESSAGE

Health Literacy:

Toolkit for Physicians

By Rodolfo “Rudy” Molina, MD, MACR, FACP, 2021 BCMS President

In the January and February issues of this journal I wrote about control. So, by acknowl-
Health Literacy; some of the history behind it, it’s working definition edging this, we can and
and gave examples on some of the challenging issues we face on achiev- should admit we control
ing a more equitable healthcare system. With this article I wish to the way we communicate
provide some simple steps; a toolkit that we can all use as clinicians with our patients.
to address one of these issues. This April article, as I
I first did a literature search on “toolkits” on health literacy available mentioned earlier, is meant to address what we can do in our offices.
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for physicians. My first hit came from a government website . Now It’s a privilege to be a physician and yet one that is earned through
this is a wonderful site with numerous ideas and suggestions. It can diligence. It comes with its own vernacular, customs, symbols and
be downloaded into a 227-page PDF and if you have “all” the time in uniforms. We use that vernacular (medical jargon) to more clearly
the world or have been awarded a hefty grant to do research in this and precisely communicate with each other about our patients.
field I would highly recommend a download. However, that is not the language of our patients. To communicate
For most of us, we haven’t the time or the resources to carefully effectively with our patients, we then must step out of our world and
study this. So, as I continued my search I came to a more practical enter theirs.
site; 8-ways to Improve Health Literacy from the Institute for Health- An old friend and former elementary teacher, now deceased, told
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care Improvement . This was an easy two-page read that dealt prima- me that the mark of intelligence was measured on how well one can
rily with how we speak to our patients. It had some valuable communicate with people on all levels from the very smart to the very
suggestions on choice of words we use when speaking to them. An ignorant. As physicians, we are smart and educated. I feel we can and
example as listed in their number 5 of the 8 points suggested, choosing should be able to communicate with all. I leave you with the following
a word like “swallow” instead of “take”, or say “harmful” instead of piece of information. The root of the word doctor comes from the
“adverse”, or say “belly” instead of “abdomen”. The other seven sugges- Latin docere, meaning to teach. So, let us continue our teaching as
tions were also helpful. our title defines us.
As I mentioned, this was a fast and easy read. I then came to an
even better, or I should say shorter, site with the title: Four Simple Rodolfo (Rudy) Molina, MD, MACR, FACP is a Practicing Rheuma-
Strategies for Improving Your Patients’ Health Literacy – Advance tologist and 2021 President of the Bexar County Medical Society.
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Care Planning (ACP) Decisions . This site also provides other links,
all designed to improve how we as providers interact with our patients. References
As my search continued, I realized that COMMUNICATION was 1. https:www.ahrq.gov/sites/default/files/wysiwyg/professionals/
the underlying theme of these websites and of their toolkits. The 227- quality-safety/quality-resources/tools/literacy-toolkit/healthliter-
page PDF government site, as well as the abbreviated 8- and 4-point acytoolkit.pdf.
strategies, were all about communicating our thoughts to our patients. 2. http:www.ihi.org/communities/blogs/8-ways-to-improve-health-
Our ability to communicate is linked to the patients’ education. literacy
Educating our patient has been linked to improved medication ad- 3. https://acpdecisions.org/four-simple-strategies-for-improving-
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herence as reported by many different authors . This was published your-patients-health-literacy/
September 11, 2020, and underscores the enormous importance of, 4. https://www.medicaleconomics.com/view/patient-education-can-
yes you guessed it, communication. improve-medication-adherence
Okay, reality check, a study printed in a 2018 article in The Per-
manente Journal found that nearly 70% of health outcomes are “dri-
ven by factors beyond health care and that poverty is associated with
more years of lost-life than smoking and obesity combined”. I rec-
ognize there are factors affecting healthcare outcomes beyond our

8 SAN ANTONIO MEDICINE • April 2021