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LETTERS: Brian McKinstry Copying patients in is not as simple as it seems BMJ 2008; 337: a2687 [Full text]

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Copying is still worthwhile, at least to patients

David D Pothier, Philip J Clamp, Sarah Todhunter   (13 January 2009)

Copying is still worthwhile, at least to patients 13 January 2009
David D Pothier, Specialist Registrar in Otolaryngology Royal United Hospital, Bath, BA1 3NG, Philip J Clamp, Sarah Todhunter Send response to journal: Re: Copying is still worthwhile, at least to patients	McKinstry(1) raises an important point in response to Dr Richards’ Observations piece(2), namely how patients feel about and will benefit from being copied into their medical correspondence. This is an issue we have looked at in some depth as we had similar concerns regarding the introduction of this somewhat daunting initiative. A survey of 500 of our outpatients(3) found that 95.5% of patients liked having their letter copied to them, but what was very interesting was that 56% of patients did not expect to be able to understand all of the letter; nonetheless those who expected to understand very little still wanted to receive a copy. The issue of readability is an important one; McKinstry states that many UK patients will not benefit from these letters as a result of their levels of literacy. This is an important issue and we have measured the readability of 300 letters from our department that were copied to patients. We found that over half did not reach recommended reading standards for the UK population. This was a surprising finding as all of the doctors whose letters were included in the evaluation were fully aware that their letters would be copied to their patients. As a result of the poor readability levels of our letters we actively undertook an intervention to try to improve our letters. We were disappointed to find that we were unable to substantially improve the readability of our letters despite active teaching sessions and with all doctors involved with and committed to the project. It appears that it is not easy to confer the important messages that letters between health professionals contain and keep them readable to the majority of patients. Despite this patients want to receive their letters and we should give them this opportunity. 1. McKinstry B. Copying patients in is not as simple as it seems. BMJ 2008;337(dec10_1) 2. Richards T. Copy them in. BMJ 2008;337(nov04_3) 3. Pothier DD, Nakivell P, Hall CE. What do patients think about being copied into their GP letters? Ann R Coll Surg Engl 2007;89(7):718- 21. Competing interests: None declared