Make sure you understand doctor’s orders - try a teach-back
Teach-back is a well-recognized, evidence-based technique that doctors and other health-care providers use to evaluate patients’ understanding of instructions.
Teach-back is a well-recognized, evidence-based technique that doctors and other health-care providers use to evaluate patients’ understanding of instructions. Like it sounds, it involves simply asking a patient to repeat or “teach-back” as if they are the one giving instructions to their provider. This way, I can evaluate how well I have conveyed the information, and make any needed clarifications.
This past week, I was discussing this with a group of standardized patients, actors trained to portray patients for doctors to practice rapport building and communication skills. We all commented that teach-back is an often overlooked opportunity for doctors to be sure their instructions are thoroughly understood. At one point, one of the standardized patients made a comment that became an “aha” moment for me.
“I do my own teach-back,” she said. “I don’t wait to see whether the doctor will decide to do it. I simply ask if I can repeat the instructions to her in order to test my understanding.” I was speechless for a few seconds while I processed this.
“What a great idea,” I replied, “Teach-back should be an equal-opportunity tool for patients and doctors alike. What matters is that it is used — not who initiates it.”
Indeed, teach-back is a wonderful collaborative tool that can go a long way toward improving doctor-patient communication. Writing instructions down or having the doctor repeat them can be helpful, but neither assures thorough comprehension. Testing your understanding out loud in front of your doctor may feel a little risky or intimidating, but will likely be welcomed and appreciated.
At times it can feel challenging for doctors to explain the teach-back technique and then perform it during a time-limited office visit. I would admire and happily accept a patient’s initiative here regardless of the extra few minutes it may take.
Teach-back is a proven way to be sure you leave the office with clear instructions, which all patients deserve. It can help prevent medication errors and improve adherence to treatment regimens. Moreover, initiating a teach-back may build a stronger doctor-patient partnership and create a more satisfying patient experience.
Jeffrey Millstein, MD, is a primary-care physician at Penn Internal Medicine Woodbury Heights.