Moving from information transfer to information exchange in health in healthcare
This paper examines the challenges commonly practiced in the medical and healthcare settings, where transmitting of information are often inadequate through the use of one-way information transfer model. The case studies show how pervasive this model is in the healthcare milieus, patient encounters and health promotion programs.
The paper identifies the critical approaches to an effective communication and concludes by suggesting that all healthcare professionals move beyond traditional practices of information transfer (one-way monologue) to adopting information exchange (two-way monologue).
Gist of the paper:
Health education very often assumes that by providing information to the general public, the information disseminated is sufficient to produce improved health outcomes to the mass population. However this is a serious flaw in assumption as it disregards the social context and also assumes that the population itself have the power and agency to implement the change by acting on the information made available.
The authors have identified three main problems.
Firstly, individualist ethic. It suggests that personal healthcare is determined based on individual characteristics, behaviours and choices. As a result, the health programs developed focuses too much on personal factors for poor health and holding the patients personally accountable for their illnesses. Through moral shaming and faulting those individual themselves, these affected people will change according to the “societal norms” to the definition of a healthy body.
Secondly, privileging expert’s authority over own’s knowledge and perspectives. Very often, information in the form of expert languages were not passed down and explained to the patient. There exists a delineation of this “expert territory” where it sets a social hierarchy between the healthcare professionals and the patients. This leads to instances whereby the wrong prescription was given and too many false assumptions were made.
Thirdly, information transfer as a monologue. A very classic case due to the “existence” of hierarchal, one-sided relationship assumed by most health communication practices. The example given was an analogy to that of a teacher-student in the classroom environment. It is assumed that students (patients) considered to know nothing will act to what was taught to them.
So to better solve these problems and make the population live a healthy life, it comes down to these simple changes:
1. Instead of faulting individuals, health promotion campaigns could provide messages that contain sharing of real-life cases and realising the risks (not fear mongering!) if these lifestyles are not modified. The messages contains strong message of individual responsibility.
2. To achieve #1, thus, there needs to be an effective dialogue. A two-way communication instead of a one-way monologue channel. For example, doctors should use very simple layman’s terms (less technical jargon) and check if the patients understood what was explained to them. In addition, doctors should engage in actively with their patients which could facilitate to identity the actual cause of the illness and prescribe correct medicine. To aid the knowledge transfer, information on the related healthcare could be passed on through brochures (these days, hospital/ health ministry websites).
3. Doctors should listen to their patients regardless of their backgrounds. Doctors shouldn’t assume that their patients are clueless and patients themselves provide feedback about the medications or symptoms described. Through engaging and asking more questions to the patient, doctors could minimise greatly the medical errors.
Working in the healthcare industry (partly), honestly this is quite a boring paper as it is *already* something I see at work everyday – where residents are greatly emphasised and trained not to commit those errors. The curriculum and training for medical doctors have long addressed the above mentioned shortfalls to better serve the patients and ultimately to make the population healthier. This paper would have been relevant say, 10 years ago.
Given that society are more educated and more informed, do you raise questions or counter questions to what your doctor tells you?
And, do you tell your doctor to explain things in the most layman’s terms especially when alot of technical jargon is used? Or do you usually accept what the doctor tells you, even when you don’t even understand what he/ she is talking about as a matter of personal pride of being an educated person?
I’ll end this with a quote from my previous director (though I’ll not say his name):
“Put down your ego, always listen to the patient what he has to say. You’ll never know, that the information he countered you back comes from a proven scientific research or even one that comes from a Nobel Prize person that you yourself never heard of before. And when you actually find them out, you’ll also learn new things in the process and make you a better and knowledgeable resident (doctor).”
– Prof C. S.
Lee and Garvin. (2003). Moving from information transfer to Information exchange in health and health care. Social Science & Medicine 56: 449-464.