By Cynthia Oertel
To understand a patient, some times you need to have been a patient, says Lloyd A. Hey, MD, director of the Center for Clinical Effectiveness, and assistant professor, department of orthopaedic surgery, Duke University Medical Center, Durham, N.C.
When he was 16 years old, Dr. Hey was involved in an automobile crash. He suffered serious injuries requiring 11 orthopaedic surgeries. "It was right before my final surgery that I vowed to never forget my experiences as a patient.
"I remember having many questions about the surgeries and my rehabilitation and never getting what I felt was sufficient information," he said. "There were not many educational materials I could bring home explaining my condition or what to expect after my surgeries."
Dr. Hey took his experiences as a patient and put them to good use later in life. He became an orthopaedic surgeon, and eventually joined the Center for Clinical Effectiveness. Along with maintaining a busy orthopaedic practice, Dr. Hey has devoted a portion of his time to helping other physicians learn more about patient education.
"Right now, I am advocating the use of videos by physicians to help patients better understand their condition and treatment process," Dr. Hey said. "To understand some medical conditions and treatments, patients have an easier time visualizing the process. They like to see what will happen during the surgery, where the injured areas are located and what the damage looks like."
A handout with lots of copy and few graphic images explaining their condition can be overwhelming to some patients, says Dr. Hey. "Most likely, patients will not take the time to read it because they see a page with a lot of words and feel it contains technical jargon that they will not be able to understand," he said. "But, a video helps them visualize the medical process."
Dr. Hey presented a scientific paper at the 1998 Annual Meeting detailing how successful videotapes can be as patient education tools.
More than 300 patients were involved in the study. Dr. Hey divided the patients into three groupsógroup one viewed a 15-minute videotape on their condition (low back pain); group two was given a brochure on the topic; and group three received no patient education materials on the subject.
"Patients who saw the video received high marks in satisfaction, confidence and compliance in understanding their prescribed treatment plans," Dr. Hey said. "The brochure seemed to have a minimal effect on patient understanding."
Understanding the right way to educate patients about their condition is easy to learn, he stresses. "First, think of it as an intervention," he said. "The patient needs to understand what is expected to get better, and in return, you will be saving yourself a lot of time and money. No more phone calls asking unnecessary questions or repeat visits to help solve the problem you thought you had already fixed."
Dr. Hey believes in "patient-to-patient" contact. He keeps a list of patients willing to talk to other patients about their experiences with similar conditions. "I find most patients understand the condition better when talking to their peers," he said. "They like to hear other patients’ success stories. They tend to open up to their peers and ask more questions because they feel by sharing similar experiences that a special bond exists."
The ideal place for patient education to start is in the reception room, says Dr. Hey. "Some times when the patient gets to the examination room, it’s already is too late," Dr. Hey said. "They are frightened and forget to ask questions about their condition."
Dr. Hey’s reception room has been transformed into a patient education center. "Patients get restless, so I have videotapes playing about various orthopaedic conditions that I treat. I also have a lot of visual reading materials available for them to review and take home," he said. "Hopefully, by the time my patients are in the examination room, they have a basic understanding of their problem."
Mary and William Fleming view patient education video.