This document discusses health literacy and strategies for improving communication with patients. It defines health literacy as an individual's ability to understand health information to make appropriate health decisions. About 1/3 of the US population has low health literacy, including the elderly, poor, minorities, and those for whom English is not their first language. Low health literacy can lead to missed appointments, medication errors, underuse of preventive care, and higher costs. The document recommends using plain language, visual aids, limiting information, encouraging questions, and shared decision making to improve communication with low health literacy patients. Shared decision making involves discussing options, risks, benefits, and patient preferences to make healthcare decisions together.