Do you understand what your doctor is talking about?
If not, it seems you’re not alone.
According to a recent study by researchers at UC San Francisco (UCSF), Arizona State University, and the Kaiser Permanente Northern California Division of Research most doctors often use language that is over their patients’ heads.
“One of the central communicative roles of physicians is to achieve mutual understanding or “shared meaning” with patients under their care,” the researchers wrote in their report published at ScienceAdvances. “Shared meaning, while having merit in its own right, is a determinant of a range of communication-sensitive processes and health care outcomes that emanate from a combination of physicians’ eliciting and explanatory skills. Determining whether physicians’ communication styles are associated with patients’ understanding is of tremendous clinical and public health significance.”
For the study, the researchers analyzed hundreds of thousands of secure email messages between doctors and patients using computer algorithms and machine learning to measure the linguistic complexity of the doctors' messages and the health literacy of their patients.
"There's a combination of attitudes and skills that we discovered is critical to physician-patient communication," said Dean Schillinger, MD, professor of medicine and a primary care doctor at UCSF and co-first author of the paper. "We were able to prove that this kind of 'precision communication' is important to all patients in terms of their understanding."
Experts on health literacy, as well as leading healthcare organizations, have advised that doctors always use simple language when explaining things to their patients to avoid confusing those with the least health literacy. The study found, however, that most doctors do not do this. Specifically, only about 40 percent of patients with low health literacy had doctors who used simple language with them.
“Limited health literacy (HL) impedes the ability of physicians and patients to achieve shared understanding,” the researchers wrote, “imparting a barrier to patients’ learning and understanding across numerous communication domains, including reading, writing, listening, speaking, and interpreting numerical values.”
The study found that the doctors who performed best in surveys of how well patients understood their care tended to tailor their electronic messages to their patients' level, wherever it was on the spectrum of health literacy.
"Our computer algorithms extracted dozens of linguistic features beyond the literal meaning of words, looking at how words were arranged, their psychological and linguistic characteristics, what part of speech they were, how frequently they were used and their emotional saliency," said Nicholas Duran, PhD, a cognitive scientist and associate professor at the School of Social and Behavioral Sciences at Arizona State University and co-first author of the paper.
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