According to a study by the American Health Information Management Association (AHIMA), almost 62% of Americans don’t feel confident that they understand health discussions with their doctor. This gap in understanding often leads to non-compliance and can have adverse, or even catastrophic, consequences on a patient’s health.
A patient’s understanding of their health and treatment plan depends on their health literacy—their ability to obtain, understand, and correctly use health information. Nearly half the population has limited health literacy, putting them at risk for poor outcomes. Compliance may not be a priority for patients who don’t understand how or why their actions affect their health.
The knowledge gap between clinicians and patients is a systemic problem, but the solutions start at the patient level in the examination rooms and the bedside.
So, what can one doctor or nurse do to bridge that knowledge gap, to meet each patient at their level of health literacy, knowing that understanding is so critical to the outcomes?
Even without discussing health literacy or the many social determinants that influence it, health professionals can start with one factor common to every patient—the language used when talking to them.
Bridging the Knowledge Gap
The knowledge gap between physicians and patients is often significant, with good reason. Medical information is complex, with its own vocabulary that becomes second nature to physicians through many years of study and practice. To those with limited health literacy, it’s foreign and intimidating.
Even with adequate health literacy, the words, phrases, and abbreviations used daily, like PRN, adjuvant therapy, pulmonary toilet, and diuresis, are meaningless to patients. Even more commonly used terms like acute versus chronic, malignant, and anti-inflammatory aren’t generally in a patient’s vocabulary.
To many, navigating the healthcare system is likewise intimidating. Healthcare has become big business, with hospital systems on large campuses, multiple practice specialties, and an ever-growing list of diagnostic tests, procedures, and medications.
The very language of the healthcare system, too, has become more businesslike, taking the “care” out of healthcare and further widening the gap. Even the language in fee-for-service sounds more and more transactional compared to transformative care. And it’s no wonder—fee-for-service has a foundation in billing.
A value-based, transformative primary care model emphasizes quality over quantity, focusing on physician-patient relationships, health promotion, and simplifying patient management of chronic conditions.
In transformative care, patients are not clients. Doctors are not providers. And the doctor-patient relationship is the foundation of patient care. The visits between them are not encounters. Unscheduled patient visits are not called walk-ins—we call them patients in need.
Words matter. And patients need to understand the words used to talk to them about their health.
Choose Your Words for the Best Outcomes
Everyone wants the best health outcomes for patients, but that is only possible if patients can make decisions based on a correct understanding of the information and services they need to manage their health.
Common barriers to understanding include differences in general literacy, health literacy, language, cultural customs or attitudes, and socioeconomic factors. Healthcare providers can’t change those alone, but they can address the language barrier that healthcare created.
Plain language guidelines recommend using everyday words and encouraging questions when communicating with patients, so they understand the most critical take-aways from visits:
- Their main problem
- The actions they need to take
- Why it’s essential to take those actions
The Agency for Healthcare Research and Quality (AHRQ) Health Literacy Universal Precautions Toolkit recommends actions we can take to communicate more clearly with every patient to achieve that goal.
Of course, words alone can’t close the communication gap. Real transformation is only possible with a practice-wide commitment to improving health literacy. An individual’s health literacy affects every interaction with your staff, from scheduling an appointment to how they manage their health after leaving that appointment.
The AHRQ toolkit provides a roadmap for your entire practice, from developing a literacy improvement plan, creating a supportive environment, communicating clearly, and assessing patient understanding, to tips for following up with patients.
Does your practice need a toolkit or even a plan? Maybe, maybe not. There’s a quick tool you can implement without any preparation to help answer that question. Today, before each patient walks out of the exam room, ask them to explain their next steps based on your discussion. Teach-back can be a powerful and sometimes eye-opening tool for the patient and their doctor or nurse.
Patients who understand and are actively involved in their healthcare achieve better outcomes. And that’s good medicine.
Healthcare providers became doctors and nurses to help people, especially in their times of need. The language of healthcare delivery can be transformed to help restore the sacred doctor/patient relationship.
To learn more about ChenMed’s transformative approach to primary care, download the eBook, Changing US Healthcare: Value-Based Care Explained.
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