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Numeracy and Communication with Patients: They Are Counting on Us

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Abstract

Patient-centered interactive communication between physicians and patients is recommended to improve the quality of medical care. Numerical concepts are important components of such exchanges and include arithmetic and use of percentages, as well as higher level tasks like estimation, probability, problem-solving, and risk assessment - the basis of preventive medicine. Difficulty with numerical concepts may impede communication. The current evidence on prevalence, measurement, and outcomes related to numeracy is presented, along with a summary of best practices for communication of numerical information. This information is integrated into a hierarchical model of mathematical concepts and skills, which can guide clinicians toward numerical communication that is easier to use with patients.

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Acknowledgments

We gratefully acknowledge the suggestions and review of the Health Literacy/Health Communication Working Group of the Harvard School of Public Health.

Acknowledgement of Support: Dr. Apter: NIH K02HL088469, R01HL073932. Dr. Bennett: NIH K23HD048915. Dr. Hyde: NIH R03 HD0540432.

Conflict of Interest

None disclosed.

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Authors and Affiliations

  1. Division of Pulmonary, Allergy, Critical Care Medicine, Department of Medicine, University of Pennsylvania, Philadelphia, PA, USA

    Andrea J. Apter MD, MA, MSc

  2. Section of General Internal Medicine, Department of Medicine, Boston University School of Medicine, Boston, MA, USA

    Michael K. Paasche-Orlow MD, MA, MPH

  3. Graduate School of Education, University of Pennsylvania, Philadelphia, PA, USA

    Janine T. Remillard PhD

  4. Department of Family Medicine and Community Health, University of Pennsylvania, Philadelphia, PA, USA

    Ian M. Bennett MD, PhD

  5. Nemours Center for Children’s Health Media, Alfred I. DuPont Hospital for Children, Wilmington, DE, USA

    Elana Pearl Ben-Joseph MD

  6. Research Study Coordinator, Children’s Hospital, Boston, MA, USA

    Rosanna M. Batista MPH

  7. Department of Public Health and Family Medicine, Tufts University School of Medicine, Boston, MA, USA

    James Hyde MA, SM

  8. Department of Society, Human Development, and Health, Harvard School of Public Health, Boston, MA, USA

    Rima E. Rudd ScD

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  1. Andrea J. Apter MD, MA, MSc
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  8. Rima E. Rudd ScD
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Correspondence to Andrea J. Apter MD, MA, MSc.

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Apter, A.J., Paasche-Orlow, M.K., Remillard, J.T. et al. Numeracy and Communication with Patients: They Are Counting on Us. J GEN INTERN MED 23, 2117–2124 (2008). https://doi.org/10.1007/s11606-008-0803-x

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