Better Doctors, Better Patients, Better Decisions

Abstract

In modern high-tech health care, patients appear to be the stumbling block: an uninformed, anxious, noncompliant folk with unhealthy lifestyles who demand treatments advertised by celebrities, insist on unnecessary but expensive imaging, and may eventually turn into plaintiffs. Patients’ lack of health literacy has received much attention. But what about their physicians? I show that the majority of doctors are innumerate, that is, they do not understand basic health statistics. An estimated 70%–80% of them do not understand what the results of screening tests mean. This engenders superfluous treatment, anxiety, and healthcare costs. As a consequence, the ideals of informed consent and shared decision-making remain a pipedream; both doctors and patients are habitually misled by biased information in health brochures and advertisements. I argue that the problem is not simply in the minds of doctors, but in the way health statistics are framed in journals and brochures. A quick and efficient cure is to teach efficient risk communication that fosters transparency as opposed to confusion. I report studies with doctors, medical students, and patients that show how transparent framing helps them understand health statistics in an hour or two. Raising taxes or rationing care is often seen as the only viable alternative to exploding health care costs. Yet there is a third option: by promoting health literacy, better care is possible for less money.