Are your patients health literate?

Determining a patient's health literacy can be a challenge for physicians. It's easy enough for patients to act as if they understand the nuances of their diagnoses and the resulting treatment instructions, but that apparent comprehension may be superficial or, in many cases, nonexistent. According to a recent report by the Agency for Healthcare Research and Quality, approximately 80 million Americans have limited health literacy, which means, the Institute of Medicine says, that they are unable to “obtain, process, or understand basic health information and services needed to make appropriate health decisions.” Our story addresses the problems health literacy can present in primary care and presents some ways that internists can try to ensure that patients really understand the information they're given.

As the evidence on the utility of prostate-specific antigen screening for prostate cancer continues to be questioned, internists may wonder what to tell their patients about when, how and whether to be screened. Screening can help detect prostate cancer early, but some men whose cancer is slow-growing may derive more harm than benefit from the sometimes considerable side effects of treatment. Kathy Holliman looks at the latest evidence and talks to experts about discussing the pros and cons of screening with patients at different ages and different levels of risk.

In late May, as part of the College's annual Leadership Day, ACP members visited Washington, D.C., to talk to their senators and representatives about the problems facing primary care and how the government can help work toward viable solutions. A Q&A with two researchers examines their recent study found that new primary care physicians didn't typically earn enough to cover their expenses, including loan repayment and savings, ending each month about $880 in debt. And, the latest installment of Mindful Medicine by Jerome Groopman, FACP, and Pamela Hartzband, FACP, examines how physicians can avoid a type of decision-making called “representativeness error” when faced with an atypical case presentation.

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Jennifer Kearney-Strouse