The knowledge gap between medical professionals and patients arises from the differing informational resources available to them. Additionally, their methods of acquiring and processing knowledge differ: medical professionals receive formal training, while patients learn informally, often on an as-and-when basis.

Consider the resources available to a medical professional versus a layperson. Health professionals undergo years of medical education, residency, and continuous training, equipping them with expertise in complex medical concepts, terminology, and diagnostics. In contrast, patients, with no specialist training and varying health literacy, may struggle to understand even basic medical information.

The health professional has access to expensive professional journals, medical databases, and advanced diagnostic tools. The patient typically relies on publicly available sources, often turning to general internet searches, social media feeds, and forwarded messages from friends and family. These are sources that may provide incomplete or inaccurate information.

Health professionals apply their knowledge in real-world clinical settings, gaining practical insights over time. In contrast, laypeople often lack clinical context and may struggle to apply medical advice to their own situations. Professionals may also assume that patients have a baseline level of knowledge, leading them to use domain-specific jargon. This assumption and the choice to use medical terminology can leave patients feeling intimidated or unsure about how to express their questions or concerns.

What are the effects of this knowledge gap on the patient?

One immediate effect of the knowledge gap is its impact on health literacy.  Literacy comes in many forms, including basic literacy (reading, writing, numeracy), climate literacy, civic literacy, emotional literacy, financial literacy, AI, data, digital, media, and information and political literacy. Similarly, health literacy is an umbrella term encompassing several subcategories:

• Functional Health Literacy: The ability to read, write, and understand basic health information, such as prescription labels, consent forms, and medication guides.

• Interactive Health Literacy: The ability to engage with healthcare providers, ask questions, and make informed health decisions. This is particularly vulnerable to the knowledge gap during medical encounters.

• Critical Health Literacy: The ability to evaluate health information, identify misinformation, and recognise biases in media and research studies.

• Digital Health Literacy: The ability to navigate and use digital health resources, such as telemedicine, health apps, and online medical information.

• Civic/Public Health Literacy: Understanding how policies, environmental factors, and social determinants affect health. The COVID-19 pandemic exposed varying levels of this literacy in public discourse.

• Scientific Health Literacy: The ability to comprehend scientific concepts, including interpreting statistics, clinical trials, and research findings.

How health information is communicated can either strengthen or hinder these literacies. This reinforces the argument that the knowledge gap is, to some extent, a choice. The language, phrasing, and terminology used by medical professionals and pharmaceutical companies directly affect a patient's ability to obtain, process, and understand health information.

This creates two key challenges for patients:

1. Difficulty in understanding medical instructions, whether spoken or written.

2. A lack of comprehension regarding the significance of treatment decisions—decisions made under the premise of patient-centred care and shared decision-making.

There are also time constraints in medical encounters. Doctors often have limited time due to high patient loads, leading to rushed consultations. Important information may not be conveyed, leaving patients with unanswered questions—if they even feel able to ask. Conversely, information overload can overwhelm patients and foster mistrust. A key lesson from the COVID-19 pandemic is that when the medical establishment fails to communicate clearly, people seek simpler explanations elsewhere.

Other overlooked factors in medical encounters, or in the design of written health information, include cultural perceptions of health and illness. Doctors rely on clinical evidence and protocols, which can override a patient’s personal experiences, despite the emphasis on patient-centred care. This can create a disconnect.

A new diagnosis or a difficult prognosis can provoke anxiety, fear, or denial, hindering a patient’s ability to absorb information. Poor communication can lead to misunderstandings about diagnoses, treatment options, or risks, ultimately affecting adherence and health outcomes.

If we develop written materials for the pharmaceutical industry, why focus so much on clinical encounters in primary or secondary care? Because the same communication issues persist in public health, pharma, and CROs, causing the same knowledge gap and harm to patients. It could be argued that the medical encounter provides the blueprint, the template and the tone for health communication in wider institutional settings.

Thank you for reading,

Mark Gibson

Leeds, United Kingdom, February 2025