In medicine, there is growing awareness about the crucial role health literacy can play in the health system. Generally, the focus lies on functional health literacy, which is closely linked to the common understanding of literacy as being able to read and write. Useful rules of communication are available for fostering patients' literacy. However, critical literacy is a much more demanding concept. Here the hermeneutics of biomedical knowledge plays is important, and so far rather neglected. The physician--and in particular the general practitioner--has an important part in this process, as a guide and a teacher. For this, it is necessary to have educational professionalism that goes beyond applying communication rules. It is important to know that the process of teaching and learning is not transmissive but constructive. Educational reconstruction is a useful instrument for taking this into account.
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