Ophthalmology Business

NOV 2012

Ophthalmology Business is focused on business topics relevant to the entrepreneurial ophthalmologist. It offers editorial, opinion, and practical tips for physicians running an ophthalmic practice. It is a companion publication of EyeWorld.

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by William B. Rabourn Jr. Y ou tell your patients what they need to do and warn them what they should not do; they appear to understand. You drive your message home by handing them written instructions or printed materials. Later, it becomes apparent that some of them have not followed your instructions. Why would they place themselves at risk for suboptimal results? These patients, while motivated to comply, may be "health illiterate," ill-equipped to act upon written and oral instructions you and your staff give them. Illiteracy, health illiteracy, and non-compliance go hand-in-hand Roughly 20% of Americans read at or below fifth grade level. Another 36% of American adults are considered functionally illiterate, and if your patient population skews to age 60 and over, as many as two-thirds of them may have inadequate or only marginal literacy skills. Functional illiteracy and health illiteracy go hand-in-hand. I can hear it now: "Not in MY back yard." Your patients are all "above average," and your practice's affluent and educated demographic insulates you from this problem. You may be confident that if the occasional literacy-challenged patient does find his or her way to your office, you will be savvy enough to spot the problem. You can't tell by looking While some functionally illiterate individuals are not too difficult to spot, studies have shown that physi- cians are able to identify only 20% or so of those who read at or lower than the third-grade level. Most of these individuals actually have at least average intelligence and have learned compensations that mask their impairment. Don't expect them to disclose their problem to you. Due to the shame and stigma associated with their deficit, fewer than half of them have even admitted it to their spouse or a family member. It does- n't matter how affluent your patients appear to be, the functionally illiter- ate are everywhere, in nearly every walk of life, in every socioeconomic group. They develop cataracts and vision-threatening conditions at the same rate as the rest of the popula- tion, and they are coming to you for help. In fact, one of the poised and articulate patients you saw today in your office may be struggling with this problem. Are your written materials meeting this challenge? Most written healthcare instructions are simply beyond the understand- ing of patients with low or marginal reading skills. For the most part, however, these patients are motivat- ed to understand and comply, but even if they manage to decipher your pre- or post-surgery instruc- tions, they are poorly equipped to analyze and synthesize the informa- tion. Come through loud and clear to ALL of your patients While we are not adept at spotting which of your patients face literacy challenges, we do not need to identi- November 2012 • Ophthalmology Business eZine continued on page 12 11

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