Analysis reveals potential racial bias in how doctors document patient trustworthiness

Racial bias in healthcare is a serious issue that continues to affect the quality of care that patients receive. A recent study published in the open-access journal PLOS One has shed light on this issue, revealing that clinicians are more likely to question the credibility of Black patients compared to white patients based on their medical records.

The study analyzed over 13 million electronic health records (EHR) notes from a large health system in the mid-Atlantic United States, written by over 12,000 clinicians between 2016 and 2023. Using artificial intelligence tools, the researchers identified language in the notes that suggested the clinician doubted the sincerity or narrative competence of the patient. Terms such as “claims,” “insists,” or “adamant about” symptoms were flagged as undermining patient credibility.

Overall, less than 1% of the medical notes contained language undermining patient credibility, with about half undermining sincerity and half undermining competence. However, notes written about non-Hispanic Black patients had higher odds of containing terms undermining credibility, sincerity, or competence compared to notes about white patients. Additionally, notes about Black patients were less likely to have language supporting credibility than notes about white or Asian patients.

While the study had limitations, such as only using data from one health system and not considering clinician characteristics like race, age, or gender, the findings are still significant. The authors suggest that clinician documentation undermining patient credibility may stigmatize Black individuals and call for increased awareness of unconscious biases in medical training. They also recommend programming AI tools used for writing medical notes to avoid biased language.

Ultimately, the goal is to eliminate credibility bias in healthcare and ensure that all patients, regardless of race, feel heard and taken seriously by their healthcare providers. By raising awareness of these issues and working towards more equitable practices, we can strive towards a more inclusive and just healthcare system for all.