“I don’t want my stuff dumbed down. All my patients understand this!”

“I don’t want my stuff dumbed down. All my patients understand this!”
“This handout has worked for me for 25 years, and it doesn’t need changing.”

I confess, when I hear reactions like this I wonder: Is this health care professional specializing in diseases of the well-educated? Or dealing with medical problems possible only in those with high health literacy skills?

But is there a disease that hits only the health literate? Even if your patient population is exclusively wealthy, poor health literacy skills are not limited to a socio-economic group.

First, let me address dumbing down. Dumbing down refers to oversimplifying to the degree of losing meaning. When health education materials are edited for readability, they are not dumbed down, they are made clear, so folks without knowledge of medical jargon and biochemistry can understand them. Essential information is not removed. Just the big words which had been put in to impress.

Then, I challenge the claim that material written at a college-level is understood by everyone, and that it has actually always worked. I propose too many assumptions are made, with too little testing of data. Have you ever had a patient who did not perform as instructed? Did not take the medicine as prescribed? Did not show up for the medical test adequately prepared? Never came back for that follow-up appointment? How do you know that patient understood your communications? Did you use teach back to evaluate understanding?

And how well did you listen to that patient’s concerns? Sometimes, when a patient worries about something we professionals feel is a minor issue, it may mean that patient really doesn’t understand the problem. Rather then brush off the minor concern, the appropriate response would be to question the patient to uncover the root understanding, and correct misperceptions.

So, you tell me, “I don’t want my stuff dumbed down. All my patients understand this!” I hear you. I understand you are a good writer and know your content well. I respect that and I agree with you. But tell me more about how you know that all of your patients understand what you are communicating . . .

©(2011) Fran London, MS, RN

2 Responses to ““I don’t want my stuff dumbed down. All my patients understand this!””

1. Joan Totka says:

   October 2, 2011 at 5:43 am

   I think many things lead to this kind of thinking. One is that some feel that taking away the medical jargon takes the seriousness away from the piece, lessoning their status and authority.
   These people feel that offering the same information in a plain language way is insulting to their patients. They also have a very hard time letting go any non-essential information, like the historical pattern or discovery of the disease/condition.
   Sometimes people think that certain medical or legal words are untouchable and it would be wrong to take them out.
   I like your clear explanation of what the goals are and have found that that can be effective, but it’s a process that takes time.
2. NoTime_author says:

   October 3, 2011 at 9:03 am

   Thanks for taking the time to post these thoughtful comments, Joan. I think your key message is these health care providers are not ready to provide patient-centered care. Instead of putting the needs or interests of the patient first, they are focused on their needs to share what they know or be respected. It’s not wrong to use medical or legal words — but they need to be used in a way that respects the patient. When using words not common to everyday language, define them. Don’t wait for the patient to ask you what you mean, because many patients won’t ever ask, and then won’t ever know what you’re trying to convey. Then why waste your time teaching?

   And it is my experience that patients are never insulted by clear explanations, they are relieved to finally understand. There’s a difference between clearly explaining and talking down to someone. You can feel it in the tone.