Journal of General Internal Medicine

, Volume 23, Issue 12, pp 2117-2124

First online:

Numeracy and Communication with Patients: They Are Counting on Us

  • Andrea J. ApterAffiliated withDivision of Pulmonary, Allergy, Critical Care Medicine, Department of Medicine, University of Pennsylvania Email author 
  • , Michael K. Paasche-OrlowAffiliated withSection of General Internal Medicine, Department of Medicine, Boston University School of Medicine
  • , Janine T. RemillardAffiliated withGraduate School of Education, University of Pennsylvania
  • , Ian M. BennettAffiliated withDepartment of Family Medicine and Community Health, University of Pennsylvania
  • , Elana Pearl Ben-JosephAffiliated withNemours Center for Children’s Health Media, Alfred I. DuPont Hospital for Children
  • , Rosanna M. BatistaAffiliated withResearch Study Coordinator, Children’s Hospital
  • , James HydeAffiliated withDepartment of Public Health and Family Medicine, Tufts University School of Medicine
  • , Rima E. RuddAffiliated withDepartment of Society, Human Development, and Health, Harvard School of Public Health

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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.


numeracy health literacy health communication risk