The majority of patients do not understand their discharge instructions after leaving the emergency room:

The study, published online in July by the Annals of Emergency Medicine, found that 78 percent of patients did not understand at least one area and about half did not understand two or more areas. The greatest confusion surrounded home care “” instructions about things like medications, rest, wound care and when to have a follow-up visit with a doctor.

There are several reasons for this, including the pressure hospitals place on doctors to see more patients, poor physician communication skills, and low patient health literacy.

However, as the NY Times is wont to do, the piece takes a perspective without considering the physician’s point of view.

Each of the proposed solutions, such as dual-discharge by the nurse and doctor, and the “teach back” approach, take time. Time unfortunately, is at a shortage in the emergency setting, as EDs become more overcrowded and patients becoming less satisfied with their care. Unhappy patients can punish doctors via patient satisfaction surveys.

Combined with Medicare is punishing hospitals for high readmission rates, doctors are placed in a difficult position with pressures to maximize the number of patients seen, keeping waiting times low and patient satisfaction scores high, and spending more time at discharge.

So the solution of simply “explaining instructions better” is superficial and as always, easier said than done.