Patients Who Can't Read: Implications for the Health Care System

Our health care system requires that patients be able to read. The face-to-face words between a patient and physician embellish, reinforce, and personalize a larger framework of knowledge and learning that is transmitted through the written word. Given the increasing complexity of medical knowledge and the costs of medical illiteracy, inadequate literacy skills are an increasing barrier to good health care. In this issue of The Journal, Williams et al1 show that many English-speaking and Spanish-speaking patients do not read well enough to adequately function in health care settings. The authors go beyond comparing reading ability with the difficulty of written health materials to quantitate how illiteracy can interfere with common tasks, such as understanding how to take medication or when the next appointment is scheduled. The study is limited in that it was conducted at only two public teaching hospitals and that it did not compare patients’ ability.