Are you confused about health information? You're not alone | Lisa Fitzpatrick | TEDxMidAtlantic

We are facing a crisis of health literacy in the United States. We are bombarded by health information, but we are confused about how our bodies work and often don't understand what our doctors tell us. Fitzpatrick is spreading her message of health awareness through a video series, “Dr. Lisa on the Street,” in which she interacts with everyday people about health care topics ranging from hypertension to the flu.

Dr. Lisa Fitzpatrick, MD, MPH, MPA is a CDC-trained medical epidemiologist and board-certified infectious diseases physician with both domestic and global experience in public health. Although her career has traversed clinical medicine, prevention research and program implementation in tuberculosis, HIV and STDs, she is most passionate about improving the nation’s health literacy and demystifying health information.

This talk was given at a TEDx event using the TED conference format but independently organized by a local community. Learn more at http://ted.com/tedx

This is my dad.

He's actually one
of the smartest people I know.

As you can see, he's a Cardinals fan.

That's because we're
from St. Louis, Missouri,

which is where I grew up.

I was there a few months ago.

We were having breakfast.

We were having a conversation.

"Dad, how's your health?"

"I'm doing great!

Next week, I'm going
to see my gynecologist."

(Laughter)

"Your urologist!"

"Oh, yeah, yeah."

(Laughter)

Dad is not alone, though.

He got a little mixed up.

Raise your hand
if you've ever been confused

by a medical term
or something your doctor said.

In my 20 years of experience
in public health

and medical epidemiology and medicine,

this confusion transcends race, gender,

age, income, and geography.

That means we have a problem
with health literacy.

Health literacy is the ability

to understand and utilize
health information.

But what's interesting

is we're bombarded by health information
almost 24 hours a day.

But people are still confused.

They don't know what to eat,

how much to drink, who to see for what.

We have low health literacy.

And low health literacy can get expensive.

Latest cost estimates of health literacy,

low health literacy,

are up to $238 billion a year.

That's because people
who have low health literacy

are more likely to enter
our health care system

when they're sicker,

so they show up in the ER.

They're hospitalized.

They may even have surgery.

These are our most expensive
forms of healthcare.

Now, I've been thinking
about this for a long time.

I've been trying to figure out,

how do I use my interest and my skills

to teach people about
basic health information?

So one day I was in a bike shop,

and I met a videographer
named Francis Tatum,

and I told him about my desire
to educate people.

So together, we created
Dr. Lisa on The Street.

Take a look.

(Video) Lisa Fitzpatrick: Doctors
often speak in a language

that people don't understand.

Has this ever happened to you?

Man: Pretty much all the time.

Man: Exacerbate, I don't know that word.

Woman: Hold on, you can't extend?

LF: How does the flu spread?

Man 1: Not cooking your food properly.

Man 2: That's salmonella.
Man 1: Well, that's -

Man: No, don't want one.
I see everyone pushing it.

They keep pushing it;
everyone keep pushing it.

I'm sick of corporate America
pushing stuff on me.

LF: Shawn got some Pop-Tarts.
Shawn: Yeah.

LF: Okay, didn't you just tell me
that we have to cut down on sugar?

Shawn: I did.

LF: And you're a diabetic.
And you have Pop-Tarts and Froot Loops.

Man: These are the kidneys or lungs.

LF: You said kidneys or lungs?

Man: The kidneys or the lungs.

LF: So, that's the kidney.
This is the lung.

Woman: [Went to] the hospital
with her one day,

and she wanted to see if she was pregnant,

but she said, "Oh, I got a stomachache,"
or something like that, so it depends.

LF: You go to the emergency room,
get a physical? So do you have a -

Man: sometimes, it depends.

LF: How do you think we can get
the message out to them?

Man: The way you talkin' to me now.
Each one, teach one.

That's the way to spread the news.

LF: I'm Dr. Lisa.
I'll see you on the street.

(Applause)

So what have I learned
from walking the streets?

(Laughter)

I learned a couple of important things.

The first one is the grapevine
is a powerful educator.

Now, I suspect most of us are getting

some of our information
from the grapevine,

whether it's through casual
conversation or the media.

It's like the game of telephone.

You tell the first person,

and then by the time
it gets to the end of the line,

the message is all garbled.

But the grapevine's not all bad.

It's actually pretty effective
at transmitting information.

The problem is a lot
of the information just is not true.

(Laughter)

And when bad information
gets on the grapevine,

it creates chaos.

A fantastic example of this
is the recent Ebola scare.

Remember that?

There wasn't enough information
reaching the public,

so the grapevine took over,
and what happened?

We closed schools.

We quarantined people in hospitals.

We barred people from airplanes.

We even kept a cruise ship from docking.

That's because there wasn't enough
good information on the grapevine

to counteract all the misinformation.

This is a great example of why we need
better information on the grapevine.

Now, the second thing I learned -

and I knew this to an extent already

because everybody I talked to
on the street had a doctor.

But I learned we are failing
to educate you, our patients.

And I think we're failing
for a couple reasons.

First, because our tools are outdated.

Not just our physical tools,

but the strategies we use
to communicate with people.

For example,

this is a health literacy test.

I ask a person to read
the words on this paper.

Then I give them a score, and voila,

I'm supposed to know
if they're health literate.

Now, this test might tell me
if someone can read,

(Laughter)

but I'm pretty sure

it doesn't tell me the things
I really care about,

like, "Will she take her medications,"

or "Will he keep his appointments?"

And look at this.

I still have a fax machine in my office!

Raise your hand

if you have never used one of these.

(Laughter)

Right?

At a time when patients are asking us

to communicate with them
via text and email,

doctors are still communicating via fax,

and even my dad has a cell phone.

(Laughter)

But we're also failing

because we use language
that's comfortable for us and not you.

I asked one of my colleagues

why he wasn't testing
his patients for HIV,

and he said, "Well, I've had
most of these patients for 20 years.

It's just awkward to bring it up."

(Laughter)

So I thought for a minute, and I said,

"Do you prescribe Viagra?"

He got the message.

(Laughter)

(Applause)

He was denying his patients an opportunity
to be as healthy as they could be.

So, why does all this matter?

It matters because research shows

that for every $1 spent
on health literacy,

we can save $25.

That means if we spend
$1 million on health literacy,

we can save our system $25 million.

That's impact.

But it also matters
because of people like John.

He says things like,
"I don't trust doctors.

They're nothing but drug dealers
working for drug companies."

But then he said something
that really struck me.

He said, "Doctors don't listen.

If I go in for a headache,

I don't want you talking
to me about my liver.

I just want something for my headache."

I had to explain to him

the headache is actually a symptom
of a much bigger problem,

and it's our job to figure out
what's causing the headache.

Well, John was diagnosed
with diabetes two years ago,

but before that,

he hadn't seen a provider in 10 years.

And at that time, the doctor
told him he was pre-diabetic.

But he didn't go back
because he felt fine,

but also because he didn't like
the way the doctor spoke to him.

Fast forward, he sees
another doctor who says,

"Guess what? You have diabetes."

He puts him on medication,

but John stops taking the medication
without even talking to his doctor.

And almost a year later,

he's rushed to the emergency
room in an ambulance

in a diabetic coma,

and he spends eight days in the hospital.

He is a great example
of why health literacy matters,

and our health care system
is flooded with patients like John.

So, what can we do about it?

First, we can manage the grapevine.

The grapevine

is like ivy.

You know what happens
to ivy; you've seen it.

If you don't maintain it and control it,

it spreads like wildfire.

And bad information
travels very fast on the grapevine

because it's associated with drama,

and people usually love drama.

(Laughter)

But we don't want
to destroy the grapevine.

We actually need it.

We need it to help counteract
the misinformation.

So, what can you do?

Before spreading information
on the grapevine, verify it,

and don't believe things
just because they sound true.

Next, I think doctors
need to embrace technology,

but you have to push for it

because the change
in our healthcare system

comes from demand from you.

And nowadays, almost
everybody has a device.

I was riding my bike last week,

and I turned down this small road,

and there was a group of people
standing on the street,

and nobody waved.

Nobody even saw me

because they were all
looking down at their cell phone.

I believe if we are this
captivated by devices,

we should definitely use them
to educate people

with health information, don't you?

Audience: Yeah.

So you push your health care
providers toward technology.

Thank you, please!

Take control of your health.

Your health literacy is up to you.

So, avoid gaps in care.

Remember John?

It took him 10 years
to get back to the doctor,

but his illness
was completely preventable.

Find your health care provider.

John was frustrated

because he and his doctors
were mismatched,

and they didn't meet his expectations.

Unfortunately, there's no match.com
for doctors and patients.

(Laughter)

But that's a hint
to you entrepreneurs out there.

(Laughter)

He became frustrated
and discouraged, and he gave up,

but he was the one
who suffered in the end.

So don't be like John.

And finally,

be persistent in getting
the information you need.

Ask if you don't understand
something, unapologetically.

I know office visits are short,

but that's our problem; it's not yours.

So speak up and get the information
you need to be healthy.

I'm Dr. Lisa,

and I'll see you on the street.

(Applause)