Health Literacy

Why Medical Doctors Should Write More and Consider Creative Writing Too

A personal take, but one that was transformative for me

My writing journey started with externalizing stress. There is a stigma in talking about feelings of stress within the medical community. That is why putting thoughts creatively on paper was so important for me in my first article. I explained my thoughts on stress and burnout in the medical profession in a previous story titled The Guilt of Quitting as a Doctor and Overcoming Burnout.

Once I got that out of the way, I wanted to do what I loved doing as a doctor: teaching. Medical professionals are used to making quick decisions based on whatever information they have at the time. Is there not enough information to make the right decision? As long as you are not making the wrong one during an emergency, it’s all good.

However, the pace is both necessary when emergent situations arise and detrimental when you are trying to help a patient understand something complex. On a daily basis, I will hear people tell me, “Nobody explained it to me like that before,” when I talk about a chronic issue they have had for 10 years.

Communication opportunities are often missed as tasks pile up. However, professional and creative writing has helped me learn to slow down when communicating. Focusing on teaching and creativity in written format has made me a better doctor serving my patients more effectively. Let me explain.

Keep the health literacy of the population in mind.

Sharing information in a clear and concise way is not easy, especially in stressful medical environments. However, to decrease the chances that someone fails a medicine or worsens their chronic issues, it is important to give careful instructions.

We always write them down and hand them to people at the end of a visit, but I would be shocked if more than 1 in 4 read these “after-visit summaries.”

Most healthcare materials are written at a 10th-grade level or higher. However, most adults read between the eighth and ninth grade level. About 130 million adults in the U.S. have low literacy skills, according to a Gallup analysis of data from the U.S. Department of Education. This means more than half of Americans between the ages of 16 and 74 (54%) read below the sixth-grade level.

For the elderly and for people whose primary language is not English, the problem is compounded. The majority of patients older than 60 years perform at the lowest levels of literacy, and 80% have limited ability to fill out forms which are often a part of any medical visit. The consequences are even worse in this population because of the more numerous chronic diseases they face.

When health literacy is considered, messaging is tailored to each person’s ability to understand. A better understanding of a condition empowers them to make more informed decisions about their care.

Better communication between health professionals

Whenever you visit a doctor, you may notice them typing away on their computer while you are speaking. They usually write a “note,” which is the record of a visit. The first part of any note is the “history of present illness” or HPI.

This is where a person tells a doctor what is bothering them or what they want to get out of a visit. Listening is very important, but writing is just as important. Capturing the patient’s concerns clearly can mean the difference between noticing a small concerning detail and missing a diagnosis completely.

Now that records are often accessible to patients, it is even more important to capture the story. Reading medical records can spark confusion, fear, or anger, but good writing can minimize the risks and maximize the benefits of information sharing.

Also, the better the narrative is, the easier it is to put together a story when a medical professional is seeing a patient after a long period of time. This is even more important when sending a patient to another specialist.

If they have never seen the patient before, clear notes from their other doctors can quickly put a story together. Poor writing muddles their medical history. Every new patient is a blank page, so it is on that medical professional sitting in front of a computer to create the narrative.

While physicians must pay attention to health literacy, note-writing in a creative way is important for communication between medical professionals.

Since every visit with an established patient will not start with a review of their entire history, that step needs to be done initially. That first note and narrative set the tone for all interactions with that patient going forward.

Even though every new doctor who interacts with a patient should review the entire medical history, this is not what happens. Notes are often “copied and pasted” because a practitioner will assume someone else already did the leg work. This is dangerous for the patient and the doctor. Learning to put together a medical history and then write it clearly on paper is a skill that must be learned.

Less academic writing, more teaching and creativity

One of Harvard Medical School’s requirements for admission is one year of writing experience:

Creative, complex, and compelling discoveries in medicine involve grappling with good questions borne from close-reading analyses and careful observations. Courses used to fulfill this requirement, whether in science or other disciplines, should focus on analytical and writing skills.

It is clear from this that they want doctors to be able to write in order to produce more academic research papers. That is how academic institutions run trials and obtain grant money. They want to know that their people can write to achieve this goal.

When you look at medical students applying for residency, the amount of academic writing has ballooned over the years.

For an internal medicine applicant, the average number of publications is around 6. I can tell you that this is not easy, given the demands of medical school. For neurosurgery, the average is 29!

However, have outcomes for patients improved due to more academic writing? Of course not.

Final Words

I am not dismissing the need for academic writing. It is imperative for research, and medical students should learn how to do it properly.

However, given the state of health literacy, communicating with patients creatively is a skill that is much more important to be a doctor than writing an academic paper.

I encourage all medical professionals to do more creative writing. They will be better educators and catalysts for healing to make their patients healthier as a result. Besides, expressive writing can be therapeutic for doctors and patients.

Thank you for reading my story. I wish you a healthy life.