Patient Education Ain’t Simple … or Cheap!

What does patient education look like?  And how much should it cost a patient?

Several weeks ago, my friend visited the doctor complaining of an uncomfortable feeling in his chest, only to be admitted via the emergency room to the hospital.  After several procedures, new drugs and four days, he was released.  But just before he was discharged, a nurse brought in loads of loose papers, pamphlets and a checklist from the many doctors he had seen over the course of his stay.  After stuffing this new material into his small duffle bag, which already contained several groups of papers explaining his two new diets, he was deemed ready to go.  

After a few weeks I checked in on him to see how he was doing and to see if he had finished reviewing all the information in his new ‘training modules’.  He said they were still in the duffle bag.  Occasionally he thinks about going through them, but hasn’t just yet.  Strange.  I mean it was a pretty serious diagnosis, and there was a lot he needed to know about his new condition and new drugs. Most importantly, he needed to know how to live with them.

Perhaps it was the format of the information?  I’m not the expert on teaching methods, but sending a patient home from the hospital with a duffle bag filled with disparate materials is probably not the best way to reach healthy compliance numbers.  I mean really, how effective is it to have a diet educator explain how to eat healthier using a 10-page form as part of a 15-minute presentation? Not to mention the next diet educator, never having a conversation with the first one, using a different 10-page document with her 15-minute presentation.  Add on a few cardiac specialists, several nurses and couple of internists and there you have it, a duffle bag full of reading material. But, he said, every person ended their presentation with “take a look at this material and let me know if you have any questions.”  We both laughed.

So patient education is really a misnomer. Maybe it should be called patient ‘go get’ education.  At this hospital, and I’m sure they’re not alone, no one seemed to have time to educate my friend on his life threatening disease.  It’s all up to him.  So if that’s true it should be offered at no cost to him, right?  My friend mentioned that his treatment, drugs and ‘4-day stay’ cost more than six figures.  Wow!  So I asked if the bill itemized all that education he brought home and received while he was there.  He said yes, it was $111.00.  Mmmmm, so to print out a duffle bag full of papers the hospital charges a patient $111.00.

The percentage of the US population with at least one hospital stay in the past 12 months is about 7%–8%. In 2006, that translated to about 35 million hospital discharges.  In 2007, there were 1.2 billion visits to physician offices, hospital outpatient departments, and emergency departments.*  At $111.00 per patient for education, that’s an awful lot of money.  So Hospital USA, if you’re out there reading this, I think there are some more effective and less expensive alternatives we should explore to provide a better means of educating your very sick patients.

[Source: Centers for Disease Control and Prevention, Health, United States, 2009 Report, Executive Summary, page 4.]