Better healthcare needs clearer communication with patients

Imagine leaving a hospital with a prescription but still wondering: which medicine should I take first? The information is on the prescription, but communication failed. At the heart of healthcare is a goal: better health and wellbeing. Information, concerns, instructions, and decisions exchanged between patients and healthcare professionals must therefore be “translated” into understanding and appropriate action.

There is evidence from Bangladesh that medical language can create real difficulties for patients. In a 2019 exploratory study published in BJGP Open, Badrul Alam Bhuiyan and colleagues surveyed 50 Bangladeshi adults online. Of the respondents, 44 percent identified English as the language used in prescriptions, while 26 percent reported a mixture of Bangla and English. Around 30 percent could not understand the medical language used by doctors. More broadly, many participants felt that medical language was affecting the treatment process, with 48 percent identifying it as a barrier to effective healthcare. The small, non-representative sample means these figures cannot be treated as a national estimate, but the study raises an important question: what is the value of medical instructions if the patient cannot understand them?

Tap here to add The Daily Star as a trusted source

But the problem can begin even before a prescription. Gastroenterology, neonatology, or internal medicine—a specialist’s title can be medically precise yet meaningless to someone unfamiliar with it. Moreover, patients need to know not only the possible side effects of medicines, but what they mean and what action they require. Without adequate counselling, someone may be worried about an expected reaction, stop a medicine without consulting a professional, or fail to recognise an urgent symptom.

The need for clear communication becomes even more evident in the process of informed consent. A 2019 study of 190 mothers at two tertiary hospitals in Dhaka, published in the European Journal of Midwifery by Md Abdul Karim and colleagues, found that although consent was obtained from 95 percent of mothers before vaginal delivery, the process did not ensure informed consent, with mothers given no opportunity to express their preferences or choose alternatives. The study was limited to two hospitals and involved data collected in 2015, but it illustrates a crucial distinction: obtaining a signature is not the same as achieving informed participation.

Similarly, a 2021 mixed-method study published in Reproductive Health examined physician-patient communication around Caesarean-section decisions in eight district public hospitals in Bangladesh. Sathyanarayanan Doraiswamy and colleagues observed 306 labour situations and found that 92.5 percent of encounters received low overall scores for shared decision-making, which included presenting options, discussing advantages and disadvantages, eliciting patient preferences, and incorporating them into decisions. The researchers also identified several other factors influencing Caesarean-section decisions, including patient perceptions, physician attitudes, and health-system constraints. The findings nevertheless reinforce the importance of meaningful dialogue and patient participation.

This is closely connected to “health literacy”. The World Health Organization defines health literacy in terms of accessing, understanding, appraising, and using health information and services to promote and maintain health and wellbeing. Health education, therefore, should not stop at delivering information; it should help people understand and use it. Health promotion similarly seeks to enable people to exercise greater control over their health.

The same principle extends beyond the bedside. Public health constantly requires translation: research evidence into policy, policy into programmes, health messages into community understanding, and community concerns back into health-system decisions. What begins as information must eventually be translated into something people and institutions can understand and act upon.

There are practical ways to support this. Specialist designations on doctors’ nameplates, for example, could use familiar, organ- or disease-based terms alongside clinical jargon, helping patients understand whom they are consulting. Where possible, a bilingual approach can be adopted. In diagnostic test reports, findings and their interpretation can be presented in the standard local language. Along with the results, appropriate reference ranges or clinical decision limits can be provided, with their sources identified where relevant, followed by a note such as, “Talk to your doctor to understand what these results mean for your health.” This type of written report can prompt meaningful discussion between patients and doctors. Patient instructions and discharge information can likewise use clearer, more accessible language. After providing a prescription or specific verbal instructions, healthcare professionals can use teach-back by asking patients to explain in their own words how they will follow the advice, allowing any misunderstandings to be clarified. Health literacy skills can receive greater attention in professional education and training. Informed-consent processes can likewise place greater emphasis on explanation, questions, and participation in language that patients can comfortably understand.

This is particularly relevant to nursing, where professionals often explain medicines, provide discharge instructions, answer questions, and notice when patients are uncertain. Such communication is not secondary to care; it is part of enabling safe and meaningful care.

The larger lesson is that translation is not merely changing the language of information. It is about carrying meaning across the boundaries between information and understanding, understanding and action, and action and better health. The UN resolution speaks of clarity, dialogue, understanding, and cooperation; healthcare can apply these principles at the bedside, in health education, and across public-health systems.

The question should therefore not stop at whether information has been delivered. We should ask whether the patient has understood it, had an opportunity to question it, and knows what to do with it. A prescription that cannot be understood is incomplete communication. Healthcare professionals need not only clinical knowledge, but the ability to translate that knowledge into language, explanations, and actions that patients, families, and communities can understand. Because in healthcare, communication is not separate from care—it is part of care.

AKM Iqbal Bahar is assistant professor at KPJ Nursing College in Gazipur. He can be reached at irajiqbal.english@gmail.com. 

Views expressed in this article are the author's own. 

Follow The Daily Star Opinion on Facebook for the latest opinions, commentaries, and analyses by experts and professionals. To contribute your article or letter to The Daily Star Opinion, see our guidelines for submission.