Personal Angst

I just love that word "angst". My personal belief is "since I am old and wandering through my life" much like teen agers do, I can bring a new perspective to the term and make it my own.
Three things that are becoming apparent in my literacy search and personal experiences:

first: My research building through professional observations take on a special meaning of communication between health care providers. Weaknesses, strengths, biases, and personalities appear to intertwine with time, tasks, facilitiy mission, best practices, needs of the patient, and continuity.
If we as professionals can not communicate between ourselves, how can we communicate to patients and families. Importantly, after the communication, how is implimentation to be encouraged and expected?

Second: How will we as professional deal with those patient's who have needs that we might not recognize? The purpose of a literacy test(based on a very informal discussion) seems threatening to even the "educated". I do not know if the Ask me 3* is all that we need for all levels of literacy. Other tools such as STOFHLA, REALM, Newest Vital Sign,and others appear to provide a guide-ONLY and ONLY IF the participants are willing.
What is my main problem?
What do I need to do?
Why is it important for me to do this?
These three questions seem to transform the needs of the patient and the words of the health care provider into daily function for life.

Third: Using the Teach-Back/Show-Me Method (from Doctor D. Schillinger's work in health care literacy) appears a best practice method. The weakness lies in utalizing ONLY this method in complex medical instructions with limited time resources seems to require perfection.

Speaking personally, my MD will talk to you following all the standards, sitting at equal level, telling and asking, repeating, etc. ...but forgetting specific needs of a specific known patient while in the examining room. Then when the patient leaves a copy of the front page is given as a receipt...all instructions are on the flip side. Go figure?
Then there was one time in a rushed, crowded waiting room (where was HIPPA?) personal infomation and instructions were given without time for contemplation.