A sweeping analysis of over 13 million clinical notes reveals a troubling pattern: Black patients are more likely than white patients to have their credibility questioned by doctors. The study, led by researchers at Johns Hopkins, found that clinicians used language implying doubt—such as “claims,” “insists,” or “noncompliant”—more frequently in notes about Black patients.
This “credibility bias” was subtle but significant. While such terms appeared in less than 1% of all notes, they were disproportionately directed at Black patients. At the same time, Black patients were less likely to receive affirming language that supports their credibility. Researchers warned that these patterns may be just the “tip of an iceberg,” pointing to deeper racial disparities in how clinicians perceive and document patient behavior.
The consequences are serious. Implicit bias in medical records can erode trust, discourage patients from seeking care, and even lead to medical errors or worse. Notes that cast doubt on a patient’s sincerity or competence can also influence future clinicians, perpetuating a cycle of mistrust and unequal treatment.
Interestingly, the study found that Asian patients were more likely to receive credibility-supporting language, a result the researchers attributed to stereotypes about reliability. No significant differences were found for Hispanic or Latino patients.
The findings highlight the urgent need for awareness and training to address bias in clinical documentation—and for a more diverse medical workforce that reflects the communities it serves.
See: “Bias in the Chart? Black Patients More Likely to Be Doubted by Doctors” (August 15, 2025)
