Although doctor-patient communication is a vital part of your health care practice, studies have shown that patients don't always understand the medical terms that are part of a doctor's everyday vocabulary. It may be difficult to know whether your patient understands you. And sometimes, simply asking if they understand is not enough, because they could be ashamed or embarrassed to admit their ignorance.
Health literacy is defined as the ability to obtain, process, and understand health information and services, and according to the 2003 National Assessment of Adult Literacy, 36 percent of American adults had only basic health literacy or lower. Patients like these are less likely to understand information and act on medication instructions and appointment schedules. They are also more likely to have ongoing illnesses, visit the hospital, and go to the emergency room. This group tends to include the elderly, patients who speak languages other than English, patients who did not attend or complete high school, and adults living below the poverty line.
One way to increase patient understanding is to use plain, nonmedical language, also known as "living room language." Try explaining medical terms by breaking them down based on the word's root. For example, "cardiomyopathy" translates to "heart muscle disease" ("cardio" = heart; "myo" = muscle; "pathy" = disease).
You can also explain terms to patients using analogies, metaphors, and diagrams. An analogy will help connect the term to something the patient is already familiar with, and a diagram will help give the patient a visual understanding of the term.
Here are some of the top medical terms your patients may not understand:
Positive and negative
If a patient's test results are positive, they may think they are free of the disease or condition being tested for. In 2000, when former New York City Mayor Rudolph Giuliani was told he had a positive prostate biopsy, he thought it meant he was cancer-free. "I keep getting positive and negative mixed up," he said. "I kind of think of negative as bad and positive as good." One context in which a patient may understand the difference between positive and negative is a pregnancy test. Although they may not understand how the result is determined, most patients understand that a positive pregnancy test means the test taker is pregnant, while a negative test means she is not. Similarly, a positive biopsy — as in Mayor Giuliani's case — means cancer cells were detected.
Twice daily, every 12 hours, and other prescription labeling
A 2009 study published in the Journal of General Internal Medicine found that patients with low health literacy are more likely than those with average literacy to misunderstand prescription label instructions. Terms such as "twice daily" and "every 12 hours" add an extra mental step that creates an unnecessary cognitive burden and results in poor comprehension. Specifying a certain time each day was more easily understood, but it appeared that stating frequency using time periods rather than precise times may better reflect patients' preference to fit their drug regimen into their daily schedule.
Diet and exercise
When most people hear "diet," they think it means going on a diet when it really means the food they eat. People also tend to associate exercise with going to the gym, when it could simply mean walking or another type of physical activity. Avoiding "medicalese" when talking to patients can help reduce the potential for misunderstanding.
You might be surprised at what your patients aren't understanding. By using plain language and getting more specific when you need to, you'll cut down on confusion. In the end, it's best to form as trusting a relationship as possible with your patient. A trusting patient will be more likely to stop you and ask for an explanation, so it bodes well for you to create the right back-and-forth in order to avoid miscommunication.