Blame it on your 9th-grade English teacher. It turns out, the way she taught you to write is all wrong. And if you’re writing to influence your readers, your customers, or god-forbid your patients, it’s going to get you into trouble.

MSNBC just got around today to responding to an Institute of Medicine report, Health Literacy: A Prescription to End Confusion, first published in 2004. In Health Literacy, the IOM reported that 40 million Americans cannot read complex medical notes and texts at all, and a whopping 90 million of us have trouble understanding them. That’s half the country misunderstanding medical advice. And even for those of us who are not currently patients, there’s a critical lesson about communicating with customers.

As patients dealing with doctors, we are perpetually playing Jackie Chan to the health system’s Chris Tucker in a bad and dangerous version of Rush Hour (the movie): We don’t understand the words that are coming out of our health care providers’ mouths. And how could we? Try this sample of health information published in the Health Literacy report:

A comparison of the effectiveness of educational media in combination with a counseling method on smoking habits is being examined.

Or this one:

Therefore, patients should be monitored for extraocular CMV infections and retinitis in the opposite eye, if only one infected eye is being treated.

The problem with these statements isn’t just the daunting vocabulary. The sentence are also simply poorly written. And poorly written in predictable ways. The authors wrote in passive voice (using passive verbs, such as “is”) and stacked long clauses at the front end of the sentence. Just the way your English teacher probably taught you to write to create an aura of authority. 

If you’re writng this way, it’s backfiring and putting you or your organization at risk. We all know that simple declarative sentences are easier to read. What we didn’t know is that poor sentence construction coupled with low literacy costs lives. According to a 2007 study in the Archives of Internal Medicine, it’s the greatest contributor to mortality in the elderly after smoking.

And now that we know that half the population has trouble understanding health information, the doors are open for malpractice attorneys to claim that health care providers are culpable because they’re not communicating clearly. The argument will be that patients who lack literacy also lack informed consent, even when they receive thorough information. (See for example the story of Toni Cordell who lost her uterus because she couldn’t read very well.)

What this means to you:

If you’re a patient, it means of course that you should take pains to make sure you understand the medical information you’re given.

If you’re in customer or patient service, it means you should speak and write plainly. Your top priority must be clarity. Let the soundness of your ideas and information speak for themselves. 3rd person passive tense – “It was recommened by the committee” is no more authoritative than 1st person active – “I recommend you do it”. It’s just tougher to read. And your customers’ or patients’ lack of understanding will come back to haunt you.

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