The timely study by Olson and Windish1 demonstrated significant communication discrepancies between physicians and hospitalized patients in several aspects of care including patients' knowledge, communication regarding medication and treatment, and psychosocial interactions. Given their findings, the authors highlighted the need to identify solutions to improve communication and interpersonal skills.
Identifying key mediators in clinical relationships is essential in order to develop effective interventions. Recently, limited health literacy has been identified as a potential mediator of poor patient-physician communication.2,3 In their article, the authors suggest using limited health literacy strategies to improve patient comprehension1; however, health literacy was not measured in their analysis. In their study, assessing for the potential association between health literacy and the various communication domains may have provided insight into the large communication gap observed between patients and physicians. In another recent study, hospitalized patients with limited health literacy reported poor communication in the domains of general clarity, responsiveness to patient concerns, and explanations of care compared with patients with higher health literacy.3