1 in 6 patients report disrespectful language in medical notes

One in 6 adults, or 17.1%, have reported disrespectful or judgmental language in their medical records, and most expect worse health outcomes, according to research published Oct. 13 in JAMA Network Open.  

A rule in the 21st Century Cures Act that requires healthcare organizations to provide patients with timely, unrestricted access to their electronic health information took effect about five years ago. Those clinical notes sometimes include disrespectful and judgmental language. 

Researchers at Stanford University School of Medicine in California, Beth Israel Deaconess Medical Center in Boston and Harvard T.H. Chan School of Medicine in Boston conducted a nationally weighted survey of 500 U.S. adults to analyze the frequency and consequences of harmful language in medical records. 

Nearly 75% of survey respondents anticipated this language “would influence subsequent care from a new clinician” and expected worse health outcomes, such as a diagnosing error or incorrect medication prescription. Additionally, 435 of 500 respondents (85.5%) anticipated they would be less likely to return to the clinician. 

Surveyed from Nov. 21-Dec. 4, 83 of 500 U.S. adults reported disrespectful or judgmental language in medical records. Fifty-eight of them were portal users, and 25 were nonportal users in healthcare encounters. 

Adults with a greater likelihood of reporting disrespectful or judgmental language include patients who reported low income, those with a chronic pain diagnosis and younger patients. There were no statistically significant associations among gender, race, ethnicity or education status. 

“Fragmented care may exacerbate individual preventive care among patient groups already at risk for care discontinuity and worsen financial implications for health systems due to loss to follow-up, duplication costs, diagnostic delays, or other errors stemming from inadequate information transfer,” researchers wrote in the study’s conclusion. 

“[We] are not aware of prior literature specifically linking a chronic pain diagnosis to patient-reported [disrespectful or judgmental language],” they wrote. “Our finding may reflect dimensions of DJL experienced by patients with chronic pain that are not evident in clinician documentation-based studies, which warrants further investigation.”

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