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Ask the Tough Questions

Don't leave your doctor's office without the answers you need

Hospital readmissions are hard on the patient, but they also inflate the financial burden on the health care system. A study in the New England Journal of Medicine found that one in five Medicare patients is readmitted to the hospital within a month of discharge.

The reason: They are not told clearly how to take care of themselves at home. Researchers estimated that the cost of these unplanned return visits was $17.4 billion in 2004.

78 percent of the 140 patients questioned did not understand instructions for their care after leaving the emergency room.

In another study published last July in the Annals of Emergency Medicine, Kirsten Engel, M.D., an emergency medicine physician at Northwestern University's Feinberg School of Medicine, and her colleagues looked at patients' understanding in four areas: diagnosis, treatment in the ER, instructions for at-home care, and hospital discharge instructions.

“We found that 78 percent of the 140 patients questioned did not understand instructions for their care after leaving the emergency room,” Engel says.

Further, Engel says, “only 20 percent recognized that they had difficulties understanding information given to them.” So if a patient doesn’t know what he or she doesn’t know, where do we go from here?

“Having a meaningful conversation with a health care provider is a skill that needs to be developed,” says Nancy Whitelaw, director of the Center for Healthy Aging at the National Council on Aging. “There are accessible, convenient community-based programs that give people the confidence to have conversations with their providers.”

Developing that skill may mean the difference between life and death. “We learn it’s not polite to argue,” says retired ship captain Carpenter. “But you have to take charge of your own health. You pay a price for passivity.”

Next: How to ask good questions. >>

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