Clever Patients and Patient Education

During my two weeks in the Rural Western Cape, only two of my patients had finished high school. One was an elderly lady from a privileged background.

It was shocking to see how low the literacy rates were in that little place and how that affected patient education. Medicine compliance, smoking cessation, family planning… it’s tough. Especially with the high rates of FAS in the region (lots of vineyards).

But the biggest lesson was not health education to these patients. Rather, I learned not to slack on health promotion of the more “educated” patients. I look at my class, of whom probably 50% smokes regularly. Intelligent people make stupid life decisions.

I almost skimped on speaking to my patient (who had finished high school many years ago) about smoking cessation. Good thing I changed my mind. Turns out he thinks that puffing eliminates the cancer risk. So we had a nice discussion about oral cancer (yum).

You want to save the world? Figure out why health promotion rarely works. And find a way of making it work.

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