Study of medical charts finds Black patients more likely to be doubted by doctors

Black patients were more likely than white patients to have notes from their clinicians questioning their sincerity or competence, a study found (Source: “Bias in the Chart? Black Patients More Likely to Be Doubted by Doctors,” MedPage Today, Aug. 15).
 
In a cross-sectional analysis of more than 13 million notes in electronic health records, Black patients had higher odds of having credibility-undermining terms in their documentation compared with white patients, as well as lower odds of credibility-supporting language, reported Mary Catherine Beach, MD, MPH, of the Johns Hopkins School of Medicine in Baltimore, and colleagues in the journal PLoS One.
 
Undermining terms included those implying doubt about symptoms ("claims," "insists"), ability to follow instructions ("poor historian," "noncompliant"), or suspected drug-seeking behavior. Such language appeared in fewer than 1% of all notes, but the authors of the study warned that it may represent the "tip of an iceberg," pointing to broader racial disparities in how clinicians assess credibility.
 
Such implicit bias can erode trust, make patients less likely to seek future care or follow medical guidance, and even lead to medical errors or death, the authors wrote. Biased notes also may influence the attitudes and decisions of clinicians who read them in the future, further perpetuating inequities in care.