Disrespectful Language In Medical Records Isn’t Rare, Survey Shows

TL;DR

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A nationally weighted survey of 500 U.S. adults found that 17.1% had encountered disrespectful or judgmental language in their own medical records or a loved one’s. Nearly three-quarters believed such language could lead to worse health outcomes, though the study measured perceptions and cannot show that the language caused harm.

A nationally weighted survey of 500 U.S. adults found that 17.1% reported disrespectful or judgmental language in their own medical records or a loved one’s, while 73.3% believed such wording could lead to worse health outcomes. The findings, reported by Natasha Steele of Stanford University School of Medicine and colleagues in JAMA Network Open, capture patients’ experiences and concerns; they do not establish that the language caused medical errors or poorer outcomes.

The survey was conducted online from November 21 to December 4, 2025. Respondents had a mean age of 48; 51% were women, 60% were white, 11% were Black and 18% were Hispanic. About 71.2% said they used a patient portal. Researchers also asked about disrespectful or judgmental language during in-person healthcare encounters: 15.6% reported experiencing it.

Respondents described potential effects on future care as well as health. Some 74.7% believed the language could influence care from a new clinician, and 85.5% said they would be less likely to return to a clinician who used it. Those figures reflect respondents’ views and stated intentions, rather than observed changes in treatment or follow-up.

In adjusted analyses, respondents with low income were more likely to report disrespectful language than those with high income (adjusted odds ratio 2.64; 95% confidence interval 1.18–5.91). The same association appeared for people with a chronic pain diagnosis compared with those without one (adjusted odds ratio 3.25; 95% CI 1.46–7.26). Reporting stigmatizing language was also associated with lower trust in clinicians’ documentation skills (adjusted odds ratio 5.76; 95% CI 2.90–11.46). These are associations, not proof of cause and effect.

Patient Trust and Continuity of Care

The findings point to a potential gap between clinical documentation and how patients experience it. If patients read notes they consider judgmental, they may trust the record or clinician less, or be less willing to return, according to their survey responses. That could matter for continuity of care, particularly if people change providers or disengage from follow-up.

The researchers said fragmented care may contribute to missed preventive care, duplicated costs, delayed diagnoses or errors linked to inadequate information transfer. Those are potential consequences discussed by the authors, not outcomes measured in this survey. The results also draw attention to differences by income and chronic pain status, though the study does not explain why those groups were more likely to report such language.

Why Patients Read Clinical Notes

The 21st Century Cures Act included an information-blocking rule requiring clinical notes to be made available to patients promptly through electronic health record portals. As more patients can read what clinicians write, the wording in records may shape how they understand their care and how they view their providers.

Steele and colleagues said stigmatizing language has been documented across healthcare settings, but that patients’ perspectives have received limited study. They called for clear standards for respectful communication in both written records and clinical interactions, and for clinical training to emphasize person-centered language, especially for groups that may face bias based on social identity.

“Clinical training programs should emphasize person-centered language, particularly since written notes are increasingly visible to patients, with special attention to populations that may be subject to bias based on social identity.”

— Steele and co-authors

What the Survey Cannot Establish

The study’s cross-sectional design records responses at one point in time and cannot establish whether disrespectful language caused distrust, changes in care or worse health outcomes. The health effects reported here are respondents’ beliefs, not verified diagnoses, medication errors or clinical results.

The researchers also relied on self-reported experiences, which may be affected by recall or reporting bias. Because the survey was conducted online, people with limited technology access or digital fluency may be underrepresented. The report does not establish how often such language appears in all medical records, which specific phrases respondents encountered, or whether reported experiences were independently verified.

Standards and Training Under Discussion

The researchers call for clear standards and clinical training focused on respectful, person-centered language in records and patient interactions. The report does not announce a new policy, implementation plan or deadline. Further research would be needed to assess how common the language is across healthcare settings and whether changes to documentation practices affect patient trust, engagement or measured health outcomes.

Key Questions

How many people reported disrespectful language in medical records?

17.1% of the 500 survey respondents said they had encountered disrespectful or judgmental language in their own records or a loved one’s. The survey relied on self-reports.

Did the survey prove that this language worsens health outcomes?

No. 73.3% believed it could lead to worse outcomes, but the cross-sectional survey measured perceptions and did not establish that wording caused medical errors or poorer health.

What did respondents say about returning to a clinician?

85.5% said they would be less likely to return to a clinician who used disrespectful or judgmental language. This was a stated intention, not a measure of actual follow-up behavior.

Which groups were more likely to report such language?

In adjusted analyses, respondents with low income and those with a chronic pain diagnosis were more likely to report it than their respective comparison groups. The study found associations but does not establish their cause.

Source: rss