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Patient-provider communication and low-income adults: Age, race, literacy, and optimism predict communication satisfaction
Patient Education and Counselling, 11/04/09

Jensen JD et al. – In low–income populations, communication satisfaction may be lower for groups that are traditionally active in doctor–patient interactions (e.g., younger patients, patients with higher literacy skills). Healthcare providers should be aware that older, non–White, optimistic, and literacy deficient patients report greater communication satisfaction than their younger, White, pessimistic, and functionally literate peers. Both groups may be coping with their situation, the former by withdrawing and the latter by actively pushing for a higher standard of care. Healthcare providers should continue to seek out ways to facilitate dialogue with these underserved groups.

Exclusive Author Commentary
Jakob D. Jensen, 11/04/09

Researchers are currently developing materials for low skill patients; for example, pamphlets and guidebooks written for individuals with less than a 4th grade reading level. This is an important line of work, and one that will benefit many underserved groups. However, the present study suggests that some of the most dissatisfied patients are high skill, low income adults. These patients have the ability to navigate complex materials, but seem to be frustrated by other real or perceived limitations. In fact, the finding that low income patients are less satisfied with their doctor-patient interactions appears to stem largely from the negative feelings of these high skill individuals. Finding ways to effectively meet the needs of this group is key. The present study suggests that high skill, low income patients are especially bothered by the amount of time they receive during care as well as a lack of outlets for their energy. Healthcare providers might engage this situation by providing more complex reading material to the patient and by noting and encouraging patient-driven education (e.g., “I’m glad to hear that you’ve been researching your diabetes online. A book you might consider reading is . . . “). Both moves would highlight the respect the healthcare provider has for the patient (and their ability) and offer an avenue for the patient to utilize advanced skill to improve their health. Electronic solutions to meeting the needs of these high skill patients are also promising, as they allow users to navigate information (e.g., screening recommendations) at their own pace (good for high and low skill groups).

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