Communication is, by definition, an act that occurs between at least two people. It happens only when one party exchanges information or news with another. Communication can be face-to-face, written down, in a TV segment or a radio broadcast – while the method may vary, it only happens if there is more than one person involved. Why then is talk about patient communication often so one-sided?

Without realizing it, many of us routinely place the onus of comprehension squarely on the shoulders of patients. Sure, we talk about ways we can empower patients and enhance communication with them, but when push comes to shove, more often than not we speak about how a person’s health literacy status—and by extension, the person themself—is responsible for comprehending or not. But where does that leave the rest of us in our role as communicators?

Perhaps the problem is in how we traditionally define health literacy.

A Google search mainly returns the Institute of Medicine’s: “Health literacy is the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions.” However, this definition only accounts for patients, and its scope is limited to merely understanding health concepts. What about the flip side, conveying the concepts? Where do the healthcare communicators fit into this – the physicians, pharmacists, pharmaceutical companies, medical journalists, market researchers, etc.?

What if we were to think of health literacy a little differently? What if our understanding of health literacy is that it is the use of a wide range of skills including reading, writing, listening, speaking, numeracy, critical analysis, communication, and interaction that allows people to act on information to live healthier lives? This definition, adapted from the Calgary Charter on Health Literacy, does not separate speakers from listeners because it acknowledges that both play a vital role in healthcare communication.

Is it fair to say, therefore, that a physician who fails to use the teach-back method, or a writer who doesn’t use plain language principles, may have high health literacy in terms of personally understanding a given healthcare topic but low health literacy when it comes to effectively communicating that topic?

All of us are responsible for our collective health, both as patients and as healthcare communicators, so isn’t it about time we in the latter group start sharing a greater accountability too?


Bill Stone

Director, Content Strategy