Saturday, July 30, 2016

The importance of educating illiterate patients


I was talking to a friend who had come back from Mayo Clinic , and he was raving about how helpful the doctors there were. They shared tons of information, so he could make a well-informed decision ; and they spent a lot of time counselling him and helping him to decide for himself. He was very impressed with how much time and trouble they  had taken in creating and disseminating patient education material. And then he said - But of course , this will never work in a country like India , where people are illiterate and poor , and cannot understand what's happening.

I had to respectfully disagree with him. Yes , we can't copy and paste the American model for patient education , but the truth is that just because people are illiterate doesn't mean that they are not able to make their decisions for themselves. In fact the poor have to be much street-smarter than us, simply in order to be able to survive .

The truth is that the opportunity to educate patients is far greater in India, because we are starting with a clean slate. While Americans suffer from an information glut, Indians are starving for health information which is designed for their needs.

As doctors , the onus is on us to think of clever way of reaching out to them and educating them . We need to start with where they are , and then hold their hand to bring them to where we want them to be. Now just because they can't read and write doesn't mean  that we can't teach them . In this day and age, it's possible to use video on a smartphone in order to make sure that patients understand what their options are , so they can make thoughtful decisions in partnership with their doctor.

The big problem is that doctors don't respect patients who are poor or illiterate. They look down upon them because they believe they won't be able to understand anything. This is actually a shortcoming on the part of the doctor - that he cannot explain in terms which are simple enough for them to
follow ! 

Because the doctor cannot explain their problem and options to them in a medium which they can understand , he then resorts to calling them stupid. Doctors need to learn new techniques in order to teach illiterate patients. An investment in these educational initiatives would provide a far better ROI because there are so many poor illiterate patients in India. If we can reach out to them, we would have a much greater impact on the health of Indians as compared to educating the urban rich.


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