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To describe physicians use of jargon with diabetes patients with limited health literacy.

We audiotaped 74 outpatient encounters and coded unclarified jargon, assigning each term a clinical function. We administered telephone questionnaires to determine if comprehension of diabetes-related jargon varied with context.

Eighty-one percent of encounters contained at least one unclarified jargon term (mean of 4/visit). Thirty-seven percent of jargon use occurred when making recommendations, and 29% when providing health education. Patient comprehension rates were generally low and never reached adequate thresholds.

Physicians caring for patients with limited health literacy employ unclarified jargon during key clinical functions.