Chester County Medicine Fall 2019 - 13

www.CHESTERCMS.org

"Doctor" means teacher,
from the Latin docere,
to teach.

clarity on themselves by saying something such as "I want to be
sure I did a good job of explaining, so can you tell me what you
understood me to say when we spoke about...."
Another way to protect patient dignity might be to say
something like "I know your wife is going to ask what we talked
about here today, can you tell me how you will explain our visit and
what you need to do to your wife...." At times, teach-back may
reveal that patients do not understand what they need to know or
what they need to do. If that happens, say something like, "I would
like to explain that again. I want to be sure we are understanding
things the same way."
Some tips for using teach-back include using a caring tone
of voice and attitude, displaying comfortable body language
and making eye contact, using plain language or 'living room'
language and avoiding using medical jargon and vague directions.
Additional suggestions for using teach-back are to ask the patients
to use their own words, ask open-ended questions that start with
"what" or "how," avoid questions that result in "yes" or "no"
answers, and asking patients to show you how to do something,
such as using their inhaler. For amusing, yet sobering, insights
regarding the power of 'show me' watch https://www.youtube.com/
watch?v=nvwR74XpKUMd.
Finally, an appropriate approach to using teach-back is to say
"To make sure I covered everything, can you tell me how you will
explain..." (new medicine, next appointment, lab tests, etc.). The
goal is to check how well you explained the health information
- not test the patient. These methods can help you a) improve
patient understanding and adherence, b) decrease call backs and
cancelled appointments, and c) improve patient satisfaction and
outcomes.

Some of the positives for using teach-back are that is can
improve patient safety and communication between the health
professional and the patient, it is inexpensive to use, it can improve
the patient's understanding and health outcomes, all of which
contribute to improved patient satisfaction resulting in improved
quality scores with potentially increased revenue.
What are the cautions regarding teach-back? It requires time
and health professionals may need to allocate extra consultation
time to encourage the patient to 'teach-back' what they have been
told; in the bigger picture, could save time from fewer call backs.
This technique could appear patronizing, and deteriorate into an
interrogation or a 'test' for patients unless used sensitively and
appropriately.
It is our hope you are intrigued with the approach of teach-back
and will consider using this simple patient education technique
in your practice. If you are worried about the impact on your
schedule, try teach-back with your last patient of the morning and
the afternoon. If you are already using teach-back, perhaps it is
time to step up your game so that everyone in the office uses the
approach when working with patients. See if there is a difference
in call backs or missed appointments or better yet, your quality
metrics improve. Teach-back could be a missing piece to your
smoothly running practice-making good practices, better.
For more information on how to implement some health
literacy strategies in your practice - please contact the Chester
County Medical Society staff at (610) 892-7750 or write
chescomedsoc@comcast.net.
Finally, for further reading go to www.cdc.gov/healthliteracy or
www.ahrq.gov for additional resources.

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http://www.chestercms.org https://www.youtube.com/ http://www.cdc.gov/healthliteracy http://www.ahrq.gov
Chester County Medicine Fall 2019

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