Patient-provider comparison of dermatology vocabulary understanding: a cross-sectional study in patients from minority ethnic groups

Abstract

Patient-centered communication is necessary for a successful clinical relationship. There has been great interest in improving communication within the field of dermatology. To identify gaps between patient comprehension of dermatology-specific vocabulary and perceived comprehension by providers. Two hundred and eighty-five patients were recruited from outpatient dermatology clinics at Boston Medical Center and East Boston Neighborhood Health Center to complete a multiple choice survey regarding comprehension of dermatology-specific vocabulary. Participating patients were 59.6% female, with ages ranging from 18 to 94 years old, and a mean age of 45. Forty-six percent of patients identified as Hispanic/Latino, 36% as White. Fifty-five percent had a high school education or lower. Forty percent had an income of < 34,999/year. Seventy providers completed a questionnaire about their perception of patient understanding of dermatology-specific vocabulary. Patient and provider data were compared. About 60% of patients did not know the meaning of metastasis or hyperpigmentation, and approximately 55% did not understand excision or autoimmune. Providers overestimated patient comprehension of benign by 38% and sunburn and symptom by approximately 32%. Provider estimation exceeded actual patient comprehension of scar and recur by 27%. Sixty-six percent of providers cited “lack of time” as the largest communication barrier, while only 7% of patients believed additional time would improve communication. Limitations include sample size and generalizability. More than half of the patients surveyed did not understand metastasis, excision, hyperpigmentation, and autoimmune. Providers overestimated patient comprehension of benign, sunburn, symptom, scar, and recur.