he berates a patient about tobacco use throughout the whole visit, the patient may not follow up on treatment, which can be very dangerous. On the other hand, if Dr. King seems aloof about the tobacco use, the patient is unlikely to quit.


Dr. King says if he can’t convince a patient to stop smoking, he sometimes refers that patient to another physician, which shocks the patient into realizing the severity of his or her condition. Dr. King says the Internet greatly changed patients’ ability to become health literate. “Some of it’s for the good, and some of it’s for the bad,” he said. Modern medicine has become so complex patients must conduct some of their own research about their condi- tions to really comprehend what a phy- sician says during an office visit, but it is difficult for patients to gauge which websites offer credible information, Dr. King says.


Physicians can help steer patients to-


ward the correct information with clear communication. (See “Health Literacy Tools,” page 48.)


“Often the physician has to really do an in-depth explanation of what he thinks is wrong with the patient and why and the therapy he’s recommending,” he said.


CDC: Beware of prescription abusers


New research underscores the need for physicians to proceed with caution when prescribing opioids to patients. “High-Risk Use by Patients Prescribed Opioids for Pain and Its Role in Overdose Deaths,” a study conducted by the Cen- ters for Disease Control and Prevention (CDC), shows patients at the highest risk of opioid overdose quite frequently have a doctor writing their prescriptions. CDC Director Tom Frieden, MD, says physicians play a crucial role in reducing patient overdoses.


“Many abusers of opioid pain reliev- 50 TEXAS MEDICINE July 2014


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