“Patient education is a monster, monster problem”

An online article described patient education as a monster, monster problem because patients don’t understand their doctors, which leads to preventable health care expenses.

Here’s what the article said:

“Patient education is a monster, monster problem,” said Matt Berry, Orca Health’s founder and CEO.

According to company statistics, more than half of all visits to a doctor’s office don’t result in optimal care because the patient doesn’t understand what the doctor is saying. This problem, called “low health literacy,” costs the nation as much as $238 billion a year, with $73 billion attributed to hospital stays caused by a patient not understanding or adhering to a doctor’s instructions.

OK, I agree.

Then the article proposed provider-prescribed apps as a solution to this monster problem.


I love apps. But really. This is an example of a solution looking for a problem.

The problem is that patients don’t understand their doctors. There’s a simple, effective, low-tech solution to this, based on evidence:

Ask the patient to teach back to you his or her understanding of what you just said. If the patient did not understand, explain it a different way, until the patient can understand it.

This is immediately available for use by all health care providers.

You want more than that? Encourage patients to take notes or record the conversation so they don’t have to memorize everything.

Monster, monster problem solved!


Wicklund, E. (2013, 1/5/14). Rx for patient engagement: Provider-prescribed apps. mHealthNews. Retrieved from http://m.mhealthnews.com/news/rx-patient-engagement-provider-prescribed-apps-mhealth-mobile

©(2014) Fran London

2 Responses to ““Patient education is a monster, monster problem””

  1. What if doctors recommend Patients bring a Scribe to any appointment where there is likelihood of bad news or where the doc plans to share treatment options for a life-altering disease like cancer or MS. On my web site, hear the testimony of a real cancer patient (PhD in Chemistry-so health literacy was not her problem) as to her experience with hearing once her doc began sharing “bad news.”

  2. Good point! Indeed, doctors often tell patients to bring a family member or friend to a procedure, so they can travel safely. But it also would be helpful to have another person present during discussions, to listen and ask questions.

    And we should keep in mind that health literacy is not the same as literacy. A person could read, but not have the ability or understanding and skills for complex self-care. As you point out, emotions could impair comprehension. That’s why teach back is so important. The patient could be a masters prepared neonatal nurse practitioner who knows little about adult diseases and treatments. We must not assume the patient understands and can follow directions based on education or socio-economic standing. Always check using teach back.

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