A new study by researchers at the University of Chicago found that Black patients were 2.54 times as likely to have at least one negative descriptor in their medical records compared to White patients. Other groups more likely to have negative descriptors included patients on government insurance such as Medicare or Medicaid and those who were unmarried.
Researchers searched the electronic health records of over 18,000 adult patients, including over 40,000 history and physical notes. They defined a list of negative descriptors that included terms such as aggressive, combative, defensive, hysterical, and resistant. Using natural language-processing techniques, they were able to parse out the contexts in which these words were used to negatively describe patients or their behaviors. When compared to demographically matched White patients, Black patients were more than twice as likely to be described in their charts using some of these negative terms.
“The language we use can exacerbate existing health disparities,” said Michael Sun, first author on the study and a third-year student at the University of Chicago Pritzker School of Medicine. “Patients can see these notes and if they see that they’ve been identified as being defensive or angry, they might not come back to see that provider again. Or, they might not feel empowered to speak up regarding their health care needs out of a fear of being viewed negatively by their providers.”
Sun added that “everyday bias is happening in our world, whether people know it or not. This work helps to show what biases exist, even within institutions and professions that are striving to be good. These biases affect patient care and they matter to the patients. As physicians, we come from a position of privilege and power. It’s our responsibility to advocate for our patients and enact change within our own organizations.”
The full study, “Negative Patient Descriptors: Documenting Racial Bias In The Electronic Health Record,” was published on the website of the journal Health Affairs. It may be accessed here.