Difficult Patients May Suffer from Low Health Literacy

While any patient can be difficult to work with, some of these relationships may be difficult to manage because patient and provider expectations aren’t aligned. This often happens when patients have low health literacy, which means they lack the ability to read, understand, and act on health information.

You may not know when your patients have little health literacy, because it doesn’t always show on the surface. However, it doesn’t hurt to design patient interactions with the assumption that patients may not always grasp what you’re trying to tell them or feel comfortable reading educational materials.

Strategies to address this health literacy gap include understanding the educational, linguistic, and cognitive challenges your patient base faces; creating forms and handouts that can be understood by patients with lower literacy featuring large fonts, simple language, and short sentences; making the environment learning-friendly, with staff available to answer questions; and, as appropriate, allowing family and friends to be present to support the patient and help them retain medical instructions. Also, clinicians should review information with patients to be sure that they understood the key points doctors or nurses were trying to make.

Given the extent to which physicians are forced to rush encounters already, some may feel exasperated at the idea of having to do more extensive patient education efforts. Others might not feel capable of redesigning their patient education literature adequately or determining what their patient base’s literacy level or linguistic needs are.

Fortunately, healthcare organizations don’t need to rush into this with both feet. Any incremental improvements you make can improve relationships and build patient engagement to some degree. It can have an impact even if clinicians ask a few basic questions about what patients do and do not know about their condition. Eventually, it would be great if the practice became highly skilled at communicating with patients who are less literate. Virtually any practice can get there, but even slight improvements to patient-clinician communication are valuable.

If you make patient information more accessible to the masses, both patients and physicians win. On the one hand, patients feel safer, understand their medical issues better, and are more likely to improve their health. Meanwhile, your practice can deliver better quality care, improve outcomes, and build trust. What’s not to like?

This article appeared in Medical Liability Monitor, December 2017 and abstracted in Fast Practice.