Anna P. Goddu|Katie J. O’Conor|Sophie Lanzkron|Mustapha Saheed|Somnath Saha|Monica E. Peek|Carlton Haywood|Mary Catherine Beach
Do Words Matter? Stigmatizing Language and the Transmission of Bias in the Medical Record
Johns Hopkins Medicine|Johns Hopkins University|Johns Hopkins Medicine|Johns Hopkins University|Johns Hopkins University|Johns Hopkins Medicine|Johns Hopkins Medicine|Johns Hopkins University|VA Portland Health Care System|University of Chicago|Johns Hopkins Medicine|Johns Hopkins University|Johns Hopkins Medicine|Johns Hopkins University
clinician bias contributes healthcare disparities language used describe patient may reflect bias although medical records integral method communicating patients studies evaluated patient records means transmitting bias one clinician another assess whether stigmatizing language written patient medical record associated subsequent physicianintrainings attitudes towards patient clinical decisionmaking randomized vignette study two chart notes employing stigmatizing versus neutral language describe hypothetical patient 28yearold man sickle cell disease total 413 physiciansintraining medical students residents internal emergency medicine programs urban academic medical center 54 response rate attitudes towards hypothetical patient using previously validated positive attitudes towards sickle cell patients scale range 735 pain management decisions residents using two multiplechoice questions composite range 27 representing intensity pain treatment exposure stigmatizing language note associated negative attitudes towards patient 206 stigmatizing vs 256 neutral p 0001 furthermore reading stigmatizing language note associated less aggressive management patients pain 556 stigmatizing vs 622 neutral p 0003 stigmatizing language used medical records describe patients influence subsequent physiciansintraining terms attitudes towards patient medication prescribing behavior important overlooked pathway bias propagated one clinician another attention language used medical records may help promote patientcentered care reduce healthcare disparities stigmatized populations