Think like a wise man but communicate in the language of the people. William Butler Yeats
An article in last week’s Wall Street Journal, got me thinking about health literacy. Failure to communicate in the language of patients can adversely impact health outcomes. A recent study conducted by University of California San Francisco and Kaiser Permanente found that diabetic patients with low health literacy were 30-40% more likely to experience dangerously low blood sugar than those who understood the medical information presented to them! I was also surprised to learn that limited health literacy is more common than I realized: patients come from all segments of society and the majority are white, native born Americans!
Given the time squeeze created by shrinking office visits I wondered how physicians and health care professionals could adequately address the serious problem of health literacy. A little research turned up several tools that test health literacy in just minutes. The Newest Vital Sign (NVS), available in both English and Spanish, was especially clever. This free program, created by the Partnership for Clear Health Communication(PCHC) with a grant from Pfizer, uses an ice cream nutrition label as the basis for estimating a patient’s health literacy. Other tools such as the REALM Short Form from the Agency for Health Care Research and Quality are also designed to rapidly test a patient’s ability to understand medical information. Results of both of these tests can help physicians understand their patients’ communication needs as well as their medical needs.
Keeping the language in patient handouts and medical forms simple is also important in addressing health literacy challenges. PCHC notes that the average American reads at the 8th to 9th grade level--yet most health materials are written above the 10th grade level! An excellent free tool, Words Count Service, quickly rates the readability of any text you select. It was a really an eye opener to play around on this site. Submit your guesses in the comment section for the grade level rating of this post—I’ll post the answer next week!
I’d also love to hear the tactics you’re using to deal with the communication challenges created by low health literacy.
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2 comments:
I agree completely - using clear language to communicate with patients is essential to providing good care, as is taking the time, and having the patience, to answer patients' questions.
Still, I worry that some nuances are lost when we reduce the quality of language in medicine. Ultimately we need better public education so that everyone will be able to understand what doctors say and the mathematical concepts, such as probabilities, by which we make informed decisions.
Hi Elaine, I think you make a good point. Its about finding the right balance. I think working on the issue from both sides, simplfying medical language and improving education of the public, may get us closer to that balance. What do you think about the Open Notes project (see 7/23 post)? Will it oversimplify medical language or help patients understand more clearly?
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