Tips For Providers


“The first detour away from a correct diagnosis is often caused by miscommunication.”
How Doctors Think, Jerome Groopman, M.D.

It’s happened to you time and again. You’re with a patient and suddenly, there’s that quizzical look – or worse, a blank stare – and silence when there should be questions. Or, a smart, educated patient confounds you because she is having chronic trouble adhering to her medication regimen. Or, a patient misses his appointment without ever calling the office. You are observing and experiencing the symptoms of one of the most common, debilitating afflictions impacting you and your patients today: low health literacy.


Health literacy – the ability to access, understand, and act on health/medical information – plays a vital role in a person’s health status. In fact, it is “a stronger predictor of a person’s health than age, income, employment status, education level, and racei.”

Many studies have shown that individuals with low health literacy are less likely to access screening and prevention services,ii take medications as directed,iii or navigate the health care system.iv They also face a far higher risk of hospitalization.v The cost of low health literacy to our economy, already estimated at more than $106 billion,vi appears likely to increase.

Health literacy requires a wide range of skills, including understanding particular medical terms, knowing what questions to ask (or that questions can be asked), being able to follow complex medication regimens for chronic diseases, and the seemingly simple ability to read an appointment slip.

These skills are needed for dialogue and discussion, for reading health information, for using medical tools like a thermometer, and for calculating timing and dosage of medicine (Institute of Medicine). These skills have become increasingly important as advances in medicine – combined with reduced hospital stays and shorter office visits – have resulted in greater numbers of patients being asked to engage in complex self-care and medication regimens with limited physician/care provider oversight.


Research shows that only about one in 10 people has the skills needed to manage his or her health and prevent disease. According to the National Assessment of Adult Literacy, only 12% of Americans have proficient health literacy. This in a country where at least 133 million people are managing a chronic illness (Centers for Disease Control).

Low health literacy affects more than 90 million Americans, and almost everyone experiences it at some point. While the more vulnerable populations include the elderly, those with low income and education levels, and the chronically ill, low health literacy is unbounded by education level or intelligence. Even those with a seemingly strong grasp on health and medical information can see their understanding slip away when faced with an unexpected diagnosis, brief illness, or basic injury.


Low health literacy is difficult to diagnose and can confound a physician/care provider at every turn. The good news is that while it is costly and frustrating, it is highly treatable.

The most effective way of combating low health literacy is by making good communication a cornerstone of your care. It’s easy – and it’s economical! Engage. Dialogue. Listen. In today’s health care climate, the provider and patient must collaborate effectively to achieve the best possible health outcome.

The benefits of positive exchanges are startling. Research shows that for patients, these helpful interactions lead to reduced stress, better medication adherence, and an increased ability to recall information correctly following an office visit. For physicians/care providers, good communication leads to higher job satisfaction and fewer medical malpractice lawsuits.

Be aware that low health literacy may be a hidden cause of a patient’s inability to adhere to a medication regimen or to seek follow-up care after a visit, and it may even explain his or her symptoms. As a routine part of your care approach, help your patients to understand diagnoses and/or treatment. Reframe or broaden your role as a physician/care provider to include teaching as an inherent part of your time spent with patients.


Say Ah! has compiled a list of tips to help you improve the health literacy of your patients as you care for them. Many of these tips address ways to improve communication, and all are designed to help you help your patients become successful partners in their own health care. Click here to read them!

i Ad Hoc Committee on Health Literacy for the Council on Scientific Affairs American Medical Association, JAMA, Feb 10, 1999.ii Doak CC, Doak LG, Root JH. The literacy problem, In: Teaching Patients with Low Literacy Skills. 2nd ed. Philadelphia: J.B. Lippincott Co: 1996: 1-9.

iii Baker DW, Parker RM, Williams MV et al. The health care experience of patients with low literacy. Arch Fam Med 1996, 5:329-334.

iv Doak CC, Doak LG, Root JH. The literacy problem, In: Teaching Patients with Low Literacy Skills. 2nd ed. Philadelphia: J.B. Lippincott Co: 1996: 1-9.

v Baker DW, Parker RM, Williams MV., Clark WS. Health literacy and the risk of hospital admission. J Gen Intern Med 1998, 13: 791-798.

vi Vernon J, Trujillo A, Rosenbaum S, DeBuono B. Low Health Literacy: Implications for National Health Policy. University of Connecticut, Oct 11, 2007.