Getting doctors to use plain language and other ways to improve patient understanding

Posted on Apr 6, 2016 in Guest blog, Health Literacy

Health professionals have the challenging job of translating the jargon they learned in school into everyday language that people can understand. The Agency for Healthcare Research and Quality (AHRQ) has help in the form of the AHRQ Health Literacy Universal Precautions Toolkit, Second Edition.

AHRQ Health Literacy ToolkitThe Toolkit is designed for primary care practices and clinics, but can also be used in other settings to improve communication and patient navigation. Health literacy universal precautions are the steps that practices take when they assume that all patients may have difficulty comprehending health information and accessing health services. This is a pretty good assumption. No matter how educated a person is, or how familiar they are with health care, fatigue, stress, or fear can interfere with understanding even the most basic health information.

Let me give you an example that I’ve published elsewhere. A few years ago my mother had strokes following hip replacement surgery. After a night of little sleep and being scared that my mom wouldn’t recover, I was having trouble following her surgeon’s explanation for the strokes. I asked him to use simple terms, but I was still confused by what he was saying. Finally, when he talked about an insult to her lungs, my frustration exploded.

“What do you mean an insult to the lungs?” I exclaimed. Did someone say, ‘Hey lungs, you’re ugly!’?” He defended himself. “’Insult’ is a perfectly good English word.” It is, but he wasn’t using it the way I usually do. When he said “insult,” he meant an injury, not a rude remark. I needed him to use health literacy universal precautions. That includes slowing down and checking that the person you’re talking to understands what you’re saying.

Health literacy and plain language, of course, are not synonymous. Of the 21 tools in the toolkit, each 3-4 pages long, several specifically promote the use of plain language. For example:

  • Tool 4: Communicate Clearly includes strategies such as:
    • Listen carefully.
    • Use plain, non-medical language.
    • Use the patient’s words.
    • Limit and repeat content.
    • Be specific and concrete.
  • Tool 13: Welcome Patients recommends reviewing signs to make sure they:
    • are visible and easy to read
    • provide clear direction
    • are written in appropriate languages
    • use graphics when appropriate.

Other tools aim to make the health care system easier to navigate and support patients’ efforts to improve their health. For example, several tools are about referring patients to non-medical resources (for example, math and adult education classes, social and other community services, assistance with paying for medicine). Others promote patients’ taking an active role in their health, for example, by asking questions and developing action plans.

The toolkit, along with the companion Guide to Implementing the Health Literacy Universal Precautions Toolkit: Practical Ideas for Primary Care Practices, are available at no cost from AHRQ’s web site.


CindyAbout the author: Cindy Brach is a Senior Health Care Researcher at the Agency for Healthcare Research and Quality and leads AHRQ’s health literacy and cultural competence activities.