Does portal writing style contribute to disparities in clinician response?

Overview

This study analyzes 3.6 million patient-initiated messages to assess disparities in clinician responses based on writing style and content.

Background

Understanding disparities in clinician response to patient messages is crucial. The rise of digital communication through patient portals has transformed patient-clinician interactions, yet disparities persist.

Data Highlights

Key Findings

• Black patients had a 3.7 percentage point lower response rate from target clinicians compared to White patients.
• Message content accounted for only 6% of the response gap for Black patients compared to White patients.
• Writing style explained 48% of the response gap for Black patients and 35% for Hispanic patients.
• Messages that included the clinician's name in the opening had a higher response rate (39%).
• Shorter messages and lack of expressive punctuation were more common among historically marginalized groups.
• Message length and sentiment were significant contributors to response rates among Medicaid beneficiaries and patients with a high school education.

Clinical Implications

Clinicians should be aware of the impact of writing style on response rates to patient messages.

Conclusion

The study highlights the significant role of writing style in clinician response disparities.

Related Resources & Content

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5. JAMA Network Open, 2026 -- Care Team Response to Patient Portal Message Content and Writing Style
6. JAMA Network Open, 2026 -- Patient-Physician Messaging by Race, Ethnicity, Insurance Type, and Preferred Language
7. ACOG, 2025 -- Effective Patient-Physician Communication
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