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Black patients 2.5x more likely to have negative descriptions on medical records, study finds

This includes terms like 'non-compliant,' 'angry' or 'resisting.'
Posted at 9:08 AM, Apr 15, 2022

Our Two Americas series focuses on many different sides to our country. The America you know, and the one you might not.

This report focuses on discrimination. A new study called "Negative Patient Descriptors: Documenting Racial Bias In The Electronic Health Record" shows Black patients are more likely to have negative descriptions in their medical records. This includes terms like 'non-compliant' or 'resisting.'

We look at how this may continue to sow the distrust many in the Black community say they feel.

If you have been to a doctor, then there is an electronic health record trailing your name.

Over the span of nearly two years, a University of Chicago medical student was able to access more than 20,000 patient records from an unnamed hospital in the Midwest, and searched for 15 key terms that described a patient's behavior.

This includes the terms 'hysterical,' 'angry,' or 'non-compliant.' The study found Black patients were 2.5 times more likely to have descriptions like these in their medical records, compared to white patients.

Third-year medical student Michael Sun co-authored this health equity study, released in January.

"All else was considered equal: The patients' sex, their medical comorbidities, their insurance provider," said Sun.

That has garnered national attention from his colleagues.

"A very common reaction from our medical providers has actually been, you know, 'I see this all the time, I see this every day, this happens,'" said Sun.

He says it becomes part of the medical record everyone treating the patient can see. "This is supposed to be the summative narrative compilation of why the patient is here. To help inform their care, and this is the notes that medical providers use to refer back to throughout the whole stay," said Sun.

This latest report by Sun puts into question whether our medical care is equitable. We showed the results of this study to Wisconsin Health Department's Chief Medical Officer Dr. Jasmine Zapata. "It's hurtful and it's hard to see this information. It's not surprising though," said Zapata.

Dr. Zapata believes much of this is implicit bias, meaning health care providers have no idea they are doing anything wrong. Which is why she calls it out when she sees it.

"Under pressure, when you're making fast decisions, your subconscious self tends to favor one thing or another. So when you have knowledge about that, then you are able to correct it," according to Zapata.

It's a reminder that no matter what field we are talking about, words matter.

Dr. Zapata says most patients do not see their medical records, but patients do have the right to request copies from their medical provider. Under HIPPA, hospitals must mail you the records within about 30 days. They may also charge you a fee.

Read the study below:

This story was first reported by Julia Fello at WTMJ in Milwaukee, Wisc.