Missing the Mark: The State of Health Care Literacy in Plastic Surgery

Background: The Institute of Medicine defines health literacy as the degree to which individuals have the capacity to obtain, process, and understand basic health information. Low health literacy is at a crisis level in the United States. Health literacy is a stronger predictor of a person’s health than age, income, employment status, education level, and race. In the plastic surgery literature to date, there is no study that evaluates health communication between plastic surgery patients and providers. This study also aims to establish the readability of the American Society of Plastic Surgeons informed consent forms. Methods: A survey instrument was designed to assess health literacy of plastic surgery patient and health communication competencies of providers. The Readability Calculator and Hemingway Editor were used to determine the readability of a sample of the American Society of Plastic Surgeons informed consent forms. Results: Twenty-one percent of patients did not complete high school. Fifty-one percent of patients agreed that better communication with their provider would improve their health. Seventy-six percent of providers agreed that they have difficulty communicating with patients with different cultural backgrounds; 29% of providers stated that they offered patients low-literacy educational material. The average readability of the informed consents distributed to plastic surgery patients is above 12th grade. Conclusions: This study identifies the gap in communication between plastic surgery patients and providers in a county hospital setting. Failure to take appropriate actions toward eliminating inherent barriers in health communication is costly to both the hospital and the patients. These findings also raise concern about the understanding of informed consent in plastic surgery patients.