Journal of General Internal Medicine

, Volume 23, Issue 12, pp 2117–2124 | Cite as

Numeracy and Communication with Patients: They Are Counting on Us

  • Andrea J. Apter
  • Michael K. Paasche-Orlow
  • Janine T. Remillard
  • Ian M. Bennett
  • Elana Pearl Ben-Joseph
  • Rosanna M. Batista
  • James Hyde
  • Rima E. Rudd


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 



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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Copyright information

© Society of General Internal Medicine 2008

Authors and Affiliations

  • Andrea J. Apter
    • 1
  • Michael K. Paasche-Orlow
    • 2
  • Janine T. Remillard
    • 3
  • Ian M. Bennett
    • 4
  • Elana Pearl Ben-Joseph
    • 5
  • Rosanna M. Batista
    • 6
  • James Hyde
    • 7
  • Rima E. Rudd
    • 8
  1. 1.Division of Pulmonary, Allergy, Critical Care Medicine, Department of MedicineUniversity of PennsylvaniaPhiladelphiaUSA
  2. 2.Section of General Internal Medicine, Department of MedicineBoston University School of MedicineBostonUSA
  3. 3.Graduate School of EducationUniversity of PennsylvaniaPhiladelphiaUSA
  4. 4.Department of Family Medicine and Community HealthUniversity of PennsylvaniaPhiladelphiaUSA
  5. 5.Nemours Center for Children’s Health Media, Alfred I. DuPont Hospital for ChildrenWilmingtonUSA
  6. 6.Research Study Coordinator, Children’s HospitalBostonUSA
  7. 7.Department of Public Health and Family MedicineTufts University School of MedicineBostonUSA
  8. 8.Department of Society, Human Development, and Health, Harvard School of Public HealthBostonUSA

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