Plain Language: Who Needs It?

Plain Language: Who Needs It?

"Low-literacy readers."
"Weak readers."
"Basic level."

These are common ways to describe patients and consumers who need content written at a fifth or sixth-grade reading level. Having co-led the Plain Language workshop at the American Medical Writers Association annual conference this year, I'm fired up about plain language and want to share some insights I think you can use.

Plain language helps everyone

Studies of plain-language materials in health care show at least two important things.

1) Patients understand, remember, and use health information better when they receive specific instructions in simple language. And this is old news -- the study is from 1975. Get the citation.

2) More education does correlate with better recall of health information. But so does the plain-language principle of sticking to a single point, or two at most. This study is much more recent - 2011.

3) Even parents with higher incomes and more education preferred a plain-language brochure prepared by Louisiana State University researchers to a Centers for Disease Control brochure written at a higher level. (Grade levels were 6 and 10, respectively.) Most parents took three times as long to read the CDC brochure, and showed 15 percent less comprehension.

Important: these numbers don't mean every parent understood 100 percent of the plain-language brochure. Rather, if a parent understood 50 percent of the Grade 6 brochure, they understood about 35 percent of the Grade 10 brochure). The only parents for whom this difference didn't show up? Parents whose reading level was already less than Grade 3.

Think "executive summary"

You can sit back and enjoy a complete article from Harvard Business Review, like this one on beating burnout. Or you can go right to the executive summary.

Why would you do that? Hmm ... the busier a reader is, the more likely he or she wants to get straight to the point. What's the message? What should I do? Harvard Business Review is for busy professionals. They might lack time to luxuriate in the findings, mulling each sentence.

Your patients are like HBR readers. No one wants to savor each word "Your child's lumbar puncture," or "Questions and answers about cataract surgery." And they don't have time or emotional capacity to do so. It's not just basic reading ability that may be ilmited - time, patience, and interest in the material probably are, too. And stress takes an enormous toll on our abiity to concentrate and understand. If your child needs a lumbar puncture, you might be reading that brochure through tears. So let's review...

What is technical language?

When I was a kid, we lived next door to a family from the Netherlands. Every so often, the parents would switch from English to Dutch to have a conversation we kids couldn't follow. (Their children could count and say the names of foods, but that was about it.)

Like a "foreign" language, technical language creates privacy. It also displays knowledge. Who has it and who doesn't? Here's an example from a novel I read this fall, A Man Called Ove by Fredrik Backman. The doctor speaks to Ove and his friend Parvaneh. Ove is hospitalized.


"Ove has a heart problem ..." he begins, following this up with a series of terms that no human being with less than 10 years of medical training or an entirely unhealthy addiction to certain television series could ever be expected to understand.

When Parvaneh gives him a look studded with a long line of question marks and exclamation marks, the doctor sighs in that way young doctors with glasses and plastic slippers often do when confronted by people who do not even have the common decency to attend medical school before they come to the hospital. "His heart is too big."

Everyone needs plain language

In a talk at the 2015 Oregon and Washington Health Literacy Conference, Dr. Brian Zikmund-Fisher noted that the 13 percent of American adults whose literacy is at a "proficient" level -- roughly, able to read materials written from Grade 9 to college - use health care materials when they are sick, scared, or hurt...or perhaps all three. All those circumstances reduce our capacity to concentrate on complex materials.

Remember those parents who took three times longer to read the brochure written at a 10th grade level, vs. the 6th grade-level brochure? Three times? And understood 15 percent less?

Ask yourself: does that extra time, that risk of poorer adherence, lower readmission rates for your hospital? Does it help you see more of the patients in your waiting room before day's end? Or does it slow everyone down and potentially worsen outcomes because you "think patients are smart enough to understand medical language" or "want all the details?" Just some things to consider next time you plan a set of web pages or a brochure.


You have the knowledge. Your health literacy is high. You're in good health as you create patient education materials from your office, or talk with patients in your clinic. And your days are incredibly busy.

Plain language is what I do ... so let me know if I can help. Email me or call (503) 734-6853 to chat.

Focus on patient education

Variety is the spice of ... work, right? For 2017, my main services are:

  • Materials for patients and the public (including marketing content for consumers)
  • Marketing comumunications for providers
  • Teaching and consulting on plain language, health literacy, and patient education

Now available for ...

  • All patient-facing materials! Forms, handouts, brochures and booklets, print and online education content, decision tools, quizzes, checklists, flyers, signs, menus...In 2016, I even edited content for a coloring book explaining radiation therapy to children.
  • Plain-language clinical trial summaries - with the new European Union regulations, this is a huge and growing area. I've been working in it since 2013.
  • Newsletter articles, fact sheets, letters and more for providers, including physicians, nurse practitioners, nurses and research staff.

Have a project in mind for 2017?
Please contact me at and let's talk. You're also welcome to call or text me at (503) 734-6853. I'd love to hear from you!

Holiday Break
Dec. 21 - Jan. 3
Available for new projects Jan. 9

Hello! I'm Dr. Genevieve Long. A medical communicator since 2002, I write and edit materials for patients and health care providers. I specialize in writing plain-language materials for patients and other health care consumers, using evidence-based health literacy principles.

I belong to the American Medical Writers Association and the Plain Language Association International. I also teach medical writing, editing, and freelance business courses through the University of Chicago's Graham School. In my spare time, I fly fish, walk my Labs, do yoga, and read -- mostly consumer health books and mystery novels.

Email me or call (503) 734-6853 to discuss your project. I'm always happy to hear from you!

Limited availability in 2017

Annual reports - Limited to 3 in 2017. West Coast only; writing, editing, or a mix of both.

Feature articles - Most referred to Barbara Schuetze and Charles Austin Muir. Please contact me for their information. These are fantastic, highly experienced writers you will love to work with.