A recent study published in JAMA Network Open reveals a troubling trend in hospital admission notes, where language expressing doubt about patient-reported clinical histories is more prevalent for non-Hispanic Black patients compared to their non-Hispanic White counterparts. The research, conducted at a large academic health system in the Northeast United States, analyzed 54,936 admission notes from 1,249 clinicians over a five-year period.
The study found that 71% of all admission notes contained what researchers termed “doubt language” – words or phrases that cast uncertainty on a patient’s reported symptoms, experiences, or health behaviors. Alarmingly, notes about non-Hispanic Black patients had 21% higher odds of containing such language compared to those about non-Hispanic White patients, even after adjusting for various patient and encounter characteristics.
Dr. Courtney R. Lee, the study’s lead author, emphasized the potential impact of this disparity: “With recent policies providing patients full access to their health records, addressing these differences in clinical documentation may be crucial for improving patient trust and experience, especially for Black patients.”
The researchers identified specific terms like “claims,” “denies,” and “reports” as examples of doubt language. They suggest that these seemingly innocuous words, rooted in medical tradition, may reflect systemic biases that undermine the credibility of racially and ethnically minoritized patients.
This study contributes to a growing body of evidence highlighting disparities in healthcare documentation. As the medical community grapples with issues of equity and bias, these findings underscore the need for increased awareness and potential reforms in clinical communication practices.
See “Race and Ethnicity and Clinician Linguistic Expressions of Doubt in Hospital Admission Notes” (October 14, 2024)
