Welcome back to Spine IQ’s Back Blog! For the month of May, we’re talking concerns involving patient education. Last week we discussed a strategy for implementing research findings directly into practice. This week we are centering our attention on a recent publication addressing how to improve communication during telehealth visits.

As the healthcare world is rapidly evolving and patients increasingly are turning toward greater adoption and acceptance of telehealth, this new method of care requires innovative communication and creates opportunities as well as challenges. Successful clinicians need to be prepared to handle these challenges before they present themselves during a tele-health appointment. This means being keenly aware of communication issues which may arise during a virtual visit and planning ahead to ensure any potential problems can be quickly identified and resolved. Health care providers are often not quick to determine if patients are fulling comprehending what information the clinician is conveying during a virtual patient encounter. (1) It can be even more difficult for both patients and providers to communicate effectively during a video visit or telephone call when subtle facial expressions, body language cues, or hand gestures are difficult to detect. Including “conversational continuers” such as “I see” or “Go on” can help your patients know you are listening to their concerns. It is also important to be concise and clear with your patient education. Patients are typically not good at remembering prior facts and incidents during telehealth interactions; they may require more repetition of information than an in-person visit (2-4). Having multiple communication channels prepared including spoken, written, or graphic versions of information for patients may be helpful in this regard.

Utilizing conversational language with patients and clearly define any specific medical terms can be a great place to start. Additionally, focusing on 1-3 need to discuss topics per visit can help to reduce patient overload. (5) Further, being prepared in advance if necessary by hiring a medical interpreter or asking a bilingual family member to be present for patients with a language barrier or utilizing a real-time captioning service for a patient who has a hearing impairment before an appointment occurs can be incredibly helpful to patients who require these services. Additionally these factors demonstrate your care and concern for the patients language or other impairments, and foster tremendous patient confidence and good will.

As you wrap up your virtual visits, keep in mind that patients forget about half of the details they are given during an appointment. (2,3) It’s important to summarize and re-iterate your ‘need to know’ topics at the end of the appointment. Encourage your patients to ask questions through an open-ended format. The authors suggest swapping “Do you have any questions?” for “What questions do you have?” as it is thought to be more likely to provoke follow-up questions from patients. Lastly, consider utilizing the top rated “Teach Back” method and ask patients to describe key details to you in their own words (5).

Remember: Patient education starts and ends with effective communication. The strategies discussed in this week’s post are not difficult to execute in your practice, however the practice rewards and patient satisfaction are almost immeasurable in your practice. One of the most frequent complaints patients express  is they have difficulty understanding their doctor given the relative short time of  the visit. The more patients understand the easier their conditions can be managed. Want to know more? Sign up to receive email alerts for the Back Blog!


  1. Coleman C. Health Literacy and Clear Communication Best Practices for Telemedicine. Health Lit Res Pract. 2020 Nov 6;4(4):e224-e229. doi: 10.3928/24748307-20200924-01. PMID: 33170288.
  2. McCarthy, D. M., Waite, K. R., Curtis, L. M., Engel, K. G., Baker, D. W., & Wolf, M. S. (2012). What did the doctor say? Health literacy and recall of medical instructions. Medical Care, 50(4), 277-282. https:// doi.org/10.1097/MLR.0b013e318241e8e1 PMID:22411440
  3. Kessels, R. P. (2003). Patients’ memory for medical information. Journal of the Royal Society of Medicine, 96(5), 219-222. PMID:12724430
  4. Agha, Z., Roter, D. L., & Schapira, R. M. (2009). An evaluation of pa­tient-physician communication style during telemedicine consulta­tions. Journal of Medical Internet Research, 11(3), e36. https://doi. org/10.2196/jmir.1193 PMID:19793720
  5. Coleman, C., Hudson, S., & Pederson, B. (2017). Prioritized health lit­eracy and clear communication practices for health care profession­als. Health Literacy Research and Practice, 1(3), e91-e99. https://doi. org/10.3928/24748307-20170503-01 PMID:31294254