Patients need clear messages to navigate medicine's maze

Experts on health literacy say that condensing medical advice to a few simple instructions may be the best way to reach patients.

By Susan J. Landers, AMNews staff. May 26, 2003.

Washington -- Even the most well-educated patients sometimes face an uphill battle in understanding complex medical instructions. But patients who don't read well or who have a limited grasp of English often have a tougher climb yet.

Medical advances are outpacing advances in patient-physician communication, said speakers at a May 7 briefing on health literacy. The briefing was sponsored by the AMA Foundation, the AMA's philanthropic arm.

Effective communication may be even more important than blockbuster medical breakthroughs. If patients can't understand a physician's instructions, all the medical advances will be useless, noted Darren A. DeWalt, MD, an instructor in general internal medicine and pediatrics at the University of North Carolina at Chapel Hill. Dr. DeWalt is also a fellow with the Robert Wood Johnson Clinical Scholars Program, where he has researched effective physician-patient communications.

Take the extra minute at the end of a visit to ask patients if they understand what they have, what they need to do about it and why they need to do it, recommended AMA Trustee Joseph A. Riggs, MD, a gynecologist from Haddonfield, N.J. That one minute can save a five- or 10-minute phone call later that evening when the patient calls with questions, or doesn't call and just gets worse, he said. Dr. Riggs is also the president of the AMA Foundation.

Health literacy goes beyond illiteracy, said David Baker, MD, chief of the division of general internal medicine at Northwestern Memorial Hospital in Chicago. The fact that many patients can read to a certain degree can even compound the problem. By watching television and listening to the radio people can get along fairly well. "But they come into the health care setting and they are all of a sudden faced with medications and instructions and all of this information written at too high a level for easy comprehension," he said.